{
"Npi": {
"NPI": "1790996973",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "THELOVEDOCTOR 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": "10526 CRYSTAL BAY DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RENO",
"MailingAddressStateName": "NV",
"MailingAddressPostalCode": "89521-4155",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "775-853-8877",
"MailingAddressFaxNumber": "775-786-8045",
"FirstLinePracticeLocationAddress": "180 W HUFFAKER LN",
"SecondLinePracticeLocationAddress": "#303",
"PracticeLocationAddressCityName": "RENO",
"PracticeLocationAddressStateName": "NV",
"PracticeLocationAddressPostalCode": "89511-2092",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "775-786-1511",
"PracticeLocationAddressFaxNumber": "775-786-8045",
"EnumerationDate": "05/27/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GALINE",
"AuthorizedOfficialFirstName": "PANAGIOTA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PH.D.",
"AuthorizedOfficialTelephoneNumber": "775-786-1511",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "0728",
"LicenseNumberStateCode": "NV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}