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1770052821 NPI number — MARGARET J HEDELIUS LCPC

NPI Number: 1770052821
Health Care Provider/Practitioner: MARGARET J HEDELIUS LCPC

Information about “1770052821” NPI (MARGARET J HEDELIUS LCPC) exists in 1770052821 in HTML format HTML  |  1770052821 in plain Text format TXT  |  1770052821 in PDF (Portable Document Format) PDF  |  1770052821 in an XML format XML  formats.

NPI Number : 1770052821 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1770052821",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HEDELIUS",
    "FirstName": "MARGARET",
    "MiddleName": "J",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "LCPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HEDELIUS",
    "OtherFirstName": "ANNE",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "LCPC",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "17 12TH AVE S STE 201",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NAMPA",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83651-3952",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "208-570-7234",
    "MailingAddressFaxNumber": "208-965-2052",
    "FirstLinePracticeLocationAddress": "17 12TH AVE S STE 201",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NAMPA",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83651-3952",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-570-7234",
    "PracticeLocationAddressFaxNumber": "208-965-2052",
    "EnumerationDate": "11/19/2018",
    "LastUpdateDate": "03/24/2022",
    "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": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "LPC-6897",
          "LicenseNumberStateCode": "ID",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "8776",
          "LicenseNumberStateCode": "ID",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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