{
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"OrgName": "ACCESSIBLE PSCYHOLOGCIAL COUNSELING SERVICES, PC",
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"FirstLineMailingAddress": "3623 LATROBE DR",
"SecondLineMailingAddress": "STE 103",
"MailingAddressCityName": "CHARLOTTE",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28211-4864",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "704-535-5831",
"MailingAddressFaxNumber": "704-364-4141",
"FirstLinePracticeLocationAddress": "PO BOX 18153",
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"PracticeLocationAddressCityName": "CHARLOTTE",
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"PracticeLocationAddressFaxNumber": "704-364-4141",
"EnumerationDate": "02/01/2007",
"LastUpdateDate": "07/01/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": "07/17/2007",
"NPIReactivationDate": "07/01/2009",
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NICHOLS",
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"AuthorizedOfficialCredential": "M.ED",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Professional Counselor",
"LicenseNumber": "3252",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}