1790186096 NPI number — MELISSA KATHERINE ESTES M.A., ATR, LPC

NPI Number: 1790186096
Health Care Provider/Practitioner: MELISSA KATHERINE ESTES M.A., ATR, LPC

NPI Number : 1790186096 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790186096",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ESTES",
    "FirstName": "MELISSA",
    "MiddleName": "KATHERINE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "M.A., ATR, LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "44081 PIPELINE PLZ STE 225",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ASHBURN",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "20147-5891",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "19420 GOLF VISTA PLZ STE 330",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LANSDOWNE",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "20176-8268",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "571-262-1479",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/06/2014",
    "LastUpdateDate": "03/11/2024",
    "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": "0701006238",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "221700000X",
          "TaxonomyName": "Art Therapist",
          "LicenseNumber": "ATR #14-156",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}