{
"Npi": {
"NPI": "1689816423",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SANDRA KAY WIENS, PHD, 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": "36 FERNWOOD DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GUILFORD",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06437-2349",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "203-453-1781",
"MailingAddressFaxNumber": "203-453-1781",
"FirstLinePracticeLocationAddress": "26 LONG HILL RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GUILFORD",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06437-1870",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "203-453-1781",
"PracticeLocationAddressFaxNumber": "203-453-1781",
"EnumerationDate": "03/25/2009",
"LastUpdateDate": "03/25/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WIENS",
"AuthorizedOfficialFirstName": "SANDRA",
"AuthorizedOfficialMiddleName": "KAY",
"AuthorizedOfficialTitle": "THERAPIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PH.D.",
"AuthorizedOfficialTelephoneNumber": "203-453-1781",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "001393",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}