{
"Npi": {
"NPI": "1659731834",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MUDD",
"FirstName": "JENNA",
"MiddleName": "LEANN",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "LPC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SHAW",
"OtherFirstName": "JENNA",
"OtherMiddleName": "LEANN",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "142 HOLLY FERN DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HARVEST",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35749-2301",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "662-341-6008",
"MailingAddressFaxNumber": "662-341-6008",
"FirstLinePracticeLocationAddress": "142 HOLLY FERN DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HARVEST",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "35749-2301",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "662-341-6008",
"PracticeLocationAddressFaxNumber": "662-341-6008",
"EnumerationDate": "03/01/2016",
"LastUpdateDate": "03/06/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "3946",
"LicenseNumberStateCode": "AL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}