1689852121 NPI number — MARY CHRISTINE WOLERY ED.S, MFT,LADC

NPI Number: 1689852121
Health Care Provider/Practitioner: MARY CHRISTINE WOLERY ED.S, MFT,LADC

NPI Number : 1689852121 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1689852121",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WOLERY",
    "FirstName": "MARY",
    "MiddleName": "CHRISTINE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "ED.S, MFT,LADC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "920 SHERIDAN LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GARDNERVILLE",
    "MailingAddressStateName": "NV",
    "MailingAddressPostalCode": "89460-6546",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "775-720-8445",
    "MailingAddressFaxNumber": "775-782-2231",
    "FirstLinePracticeLocationAddress": "1677 LUCERNE ST STE B",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MINDEN",
    "PracticeLocationAddressStateName": "NV",
    "PracticeLocationAddressPostalCode": "89423-4347",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "775-720-8445",
    "PracticeLocationAddressFaxNumber": "775-782-2231",
    "EnumerationDate": "02/07/2008",
    "LastUpdateDate": "05/13/2013",
    "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": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "538",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": "01146",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}