{
"Npi": {
"NPI": "1740712959",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DAVIS",
"FirstName": "MEGAN",
"MiddleName": "MCPEAK",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MCPEAK",
"OtherFirstName": "MEGAN",
"OtherMiddleName": "MARGARET",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "6574 STONEWAY CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BURKE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22015-4164",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "571-318-3290",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3925 OLD LEE HWY STE 52A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FAIRFAX",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22030-2426",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "571-354-0844",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/28/2017",
"LastUpdateDate": "03/28/2017",
"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": "103TS0200X",
"TaxonomyName": "School Psychologist",
"LicenseNumber": "0803000240",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}