{
"Npi": {
"NPI": "1841833050",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WORKIT HEALTH NJ LLC",
"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": "3300 WASHTENAW AVE STE 280",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ANN ARBOR",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48104-5184",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "415-842-9771",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "525 ROUTE 73 N STE 117",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MARLTON",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "08053-3422",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "609-474-0106",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/21/2019",
"LastUpdateDate": "07/16/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BARKER",
"AuthorizedOfficialFirstName": "LINDSAY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CREDENTIALING MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "734-373-0849",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"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."
}
}
}
}