{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "COUNSELING ST. CHARLES, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "109 CHURCH ST",
"SecondLineMailingAddress": "SUITE 105",
"MailingAddressCityName": "O FALLON",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63366-2894",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "636-294-0015",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "109 CHURCH ST",
"SecondLinePracticeLocationAddress": "SUITE 105",
"PracticeLocationAddressCityName": "O FALLON",
"PracticeLocationAddressStateName": "MO",
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"PracticeLocationAddressTelephoneNumber": "636-294-0015",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/20/2012",
"LastUpdateDate": "09/20/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROBERSON",
"AuthorizedOfficialFirstName": "SHANNON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "COUNSELOR",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "636-294-0015",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251B00000X",
"TaxonomyName": "Case Management Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}