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1730582453 NPI number — KELLY SCOLNICK INGLESON L.P.C

NPI Number: 1730582453
Health Care Provider/Practitioner: KELLY SCOLNICK INGLESON L.P.C

Information about “1730582453” NPI (KELLY SCOLNICK INGLESON L.P.C) exists in 1730582453 in HTML format HTML  |  1730582453 in plain Text format TXT  |  1730582453 in PDF (Portable Document Format) PDF  |  1730582453 in an XML format XML  formats.

NPI Number : 1730582453 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1730582453",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "INGLESON",
    "FirstName": "KELLY",
    "MiddleName": "SCOLNICK",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "L.P.C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "10035 E MITCHELL RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PETOSKEY",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "49770-8853",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "231-590-3167",
    "MailingAddressFaxNumber": "231-242-1659",
    "FirstLinePracticeLocationAddress": "10035 E MITCHELL RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PETOSKEY",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "49770-8853",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "231-590-3167",
    "PracticeLocationAddressFaxNumber": "231-242-1659",
    "EnumerationDate": "10/08/2014",
    "LastUpdateDate": "10/08/2014",
    "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": "6401014200",
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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