{
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"FirstLineMailingAddress": "2546 CRESTWOOD DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHATTANOOGA",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37415-6320",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "423-893-0178",
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"FirstLinePracticeLocationAddress": "6160 SHALLOWFORD RD STE 103",
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"PracticeLocationAddressCityName": "CHATTANOOGA",
"PracticeLocationAddressStateName": "TN",
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"EnumerationDate": "08/16/2007",
"LastUpdateDate": "08/16/2007",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHU",
"AuthorizedOfficialFirstName": "SUN-HWAN",
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"AuthorizedOfficialTitle": "COUNSELOR",
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"AuthorizedOfficialCredential": "PH.D., LLC",
"AuthorizedOfficialTelephoneNumber": "423-893-0178",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Professional Counselor",
"LicenseNumber": "LPC0000001513",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}