1679880678 NPI number — ADEPEJU IBIRONKE FABORO OSHAUGHNESSY L.M.H.C, L.P.C.

NPI Number: 1679880678
Health Care Provider/Practitioner: ADEPEJU IBIRONKE FABORO OSHAUGHNESSY L.M.H.C, L.P.C.

NPI Number : 1679880678 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1679880678",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OSHAUGHNESSY",
    "FirstName": "ADEPEJU",
    "MiddleName": "IBIRONKE FABORO",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "L.M.H.C, L.P.C.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "FABORO",
    "OtherFirstName": "ADEPEJU",
    "OtherMiddleName": "IBIRONKE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "44 BUCKTAIL AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PONTE VEDRA",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32081-6181",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "405-473-4945",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "44 BUCKTAIL AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PONTE VEDRA",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32081-6181",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "405-473-4945",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/12/2010",
    "LastUpdateDate": "02/02/2022",
    "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": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "6063",
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "81315",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "MH16093",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}