{
"Npi": {
"NPI": "1760665020",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CHASE",
"FirstName": "JENNIFER",
"MiddleName": "M",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "ATR-BC, LPC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GOSSELIN",
"OtherFirstName": "JENNIFER",
"OtherMiddleName": "M",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": "ATR-BC, LPC",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "310 MAIN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EAST HAVEN",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06512-2919",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "203-606-1228",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "310 MAIN STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EAST HAVEN",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06511",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "203-606-1228",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/10/2007",
"LastUpdateDate": "10/21/2016",
"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": "000703",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}