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1730025677 NPI number — ROSLYN MARIE PHILLIPS MHC, CASAC-T

NPI Number: 1730025677
Health Care Provider/Practitioner: ROSLYN MARIE PHILLIPS MHC, CASAC-T

Information about “1730025677” NPI (ROSLYN MARIE PHILLIPS MHC, CASAC-T) exists in 1730025677 in HTML format HTML  |  1730025677 in plain Text format TXT  |  1730025677 in PDF (Portable Document Format) PDF  |  1730025677 in an XML format XML  formats.

NPI Number : 1730025677 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1730025677",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PHILLIPS",
    "FirstName": "ROSLYN",
    "MiddleName": "MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MHC, CASAC-T",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "230C VILLAGE II DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HILTON",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "14468-1535",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "585-719-6732",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "480 GENESEE ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ROCHESTER",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "14611-3634",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "585-436-3040",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/24/2026",
    "LastUpdateDate": "04/24/2026",
    "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": "101YM0800X",
        "TaxonomyName": "Mental Health Counselor",
        "LicenseNumber": "018-P112016-03",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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