{
"Npi": {
"NPI": "1710567045",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HERNANDEZ MEDINA",
"FirstName": "HEIRA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LPC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "L9 CALLE LOS ALMENDROS",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MERCEDITA",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00715-2035",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "COMUNIDAD PUNTA DIAMANTE",
"SecondLinePracticeLocationAddress": "CALLE NAIRA V-28",
"PracticeLocationAddressCityName": "PONCE",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00728",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "820-400-0915",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/12/2021",
"LastUpdateDate": "02/18/2026",
"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": "79724",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "MH25430",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "23824",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"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."
}
}
}
}