{
"Npi": {
"NPI": "1780233478",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CONSCIOUSLY EVOLVED FAMILY COUNSELING, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1091",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "THOUSAND OAKS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91358-0091",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "805-574-9217",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2660 TOWNSGATE RD STE 150",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WESTLAKE VILLAGE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91361-5724",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "805-307-7933",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/05/2019",
"LastUpdateDate": "02/09/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SCHIMPFF",
"AuthorizedOfficialFirstName": "ELIZABETH",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMFT",
"AuthorizedOfficialTelephoneNumber": "805-574-9217",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QM0850X",
"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QM0855X",
"TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}