{
"Npi": {
"NPI": "1801013834",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "LIGHTHOUSE PSYCHOLOGICAL SERVICES",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "609 N HEPBURN AVE",
"SecondLineMailingAddress": "SUITE 103",
"MailingAddressCityName": "JUPITER",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33458-5015",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-745-5403",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "609 N HEPBURN AVE",
"SecondLinePracticeLocationAddress": "SUITE 103",
"PracticeLocationAddressCityName": "JUPITER",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33458-5015",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "561-745-5403",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/19/2007",
"LastUpdateDate": "03/05/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CASTIGLIA",
"AuthorizedOfficialFirstName": "STEPHANIE",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PSYD",
"AuthorizedOfficialTelephoneNumber": "561-596-6395",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103T00000X",
"TaxonomyName": "Psychologist",
"LicenseNumber": "PY6480",
"LicenseNumberStateCode": "FL",
"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."
}
}
}
}