{
"Npi": {
"NPI": "1730717877",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ZHAO",
"FirstName": "SISI",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LMHC, NCC, CRC, MA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1771 RINGLING BLVD UNIT 812",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SARASOTA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34236-6869",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "941-323-8873",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2856 UNIVERSITY PKWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SARASOTA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34243-2410",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "941-323-8873",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/01/2020",
"LastUpdateDate": "01/07/2022",
"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": "MH17912",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}