{
"Npi": {
"NPI": "1699132092",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "S. EILEEN WATTERS, LPCC-S",
"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": "21 W CENTRAL AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DELAWARE",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43015-1911",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "740-225-5342",
"MailingAddressFaxNumber": "855-217-5840",
"FirstLinePracticeLocationAddress": "21 W CENTRAL AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DELAWARE",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "43015-1911",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "740-225-5342",
"PracticeLocationAddressFaxNumber": "855-217-5840",
"EnumerationDate": "01/15/2016",
"LastUpdateDate": "01/15/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WATTERS",
"AuthorizedOfficialFirstName": "SHARON",
"AuthorizedOfficialMiddleName": "EILEEN",
"AuthorizedOfficialTitle": "PROFESSIONAL CLINICAL COUNSELOR",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPCC-S",
"AuthorizedOfficialTelephoneNumber": "740-225-5342",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251B00000X",
"TaxonomyName": "Case Management Agency",
"LicenseNumber": "E0003580",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}