NPI Code Detail JSON Logo

1841005857 NPI number — ENSIGHT MENTAL HEALTH & WELLNESS PLLC

NPI Number: 1841005857
Health Care Provider/Practitioner: ENSIGHT MENTAL HEALTH & WELLNESS PLLC

Information about “1841005857” NPI (ENSIGHT MENTAL HEALTH & WELLNESS PLLC) exists in 1841005857 in HTML format HTML  |  1841005857 in plain Text format TXT  |  1841005857 in PDF (Portable Document Format) PDF  |  1841005857 in an XML format XML  formats.

NPI Number : 1841005857 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1841005857",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ENSIGHT MENTAL HEALTH & WELLNESS PLLC",
    "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": "111 N 6TH ST STE G1",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PEKIN",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "61554-3320",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "309-810-4407",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "111 N 6TH ST STE G1",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PEKIN",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "61554-3320",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "309-810-4407",
    "PracticeLocationAddressFaxNumber": "309-354-2041",
    "EnumerationDate": "02/08/2025",
    "LastUpdateDate": "11/03/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SMITH",
    "AuthorizedOfficialFirstName": "DANIELLE",
    "AuthorizedOfficialMiddleName": "RAE",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "NP",
    "AuthorizedOfficialTelephoneNumber": "309-453-0812",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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