{
"Npi": {
"NPI": "1669125159",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ASPIRE ASSESSMENT SERVICES, LLC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3520 BEAVER AVE STE D",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DES MOINES",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "50310-3255",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "515-333-8003",
"MailingAddressFaxNumber": "515-412-1582",
"FirstLinePracticeLocationAddress": "3520 BEAVER AVE STE D",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DES MOINES",
"PracticeLocationAddressStateName": "IA",
"PracticeLocationAddressPostalCode": "50310-3255",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "515-333-8003",
"PracticeLocationAddressFaxNumber": "515-412-1582",
"EnumerationDate": "02/03/2022",
"LastUpdateDate": "02/03/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CAMERON",
"AuthorizedOfficialFirstName": "KENNETH",
"AuthorizedOfficialMiddleName": "DWAYNE",
"AuthorizedOfficialTitle": "PSYCHOTHERAPIST/PRINCIPAL ORGANIZER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMHC",
"AuthorizedOfficialTelephoneNumber": "515-557-0415",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}