{
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"FirstLineMailingAddress": "PO BOX 345",
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"MailingAddressCityName": "DANVILLE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "24543-0345",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "753 MAIN STREET, STE 1A",
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"PracticeLocationAddressCityName": "DANVILLE",
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"EnumerationDate": "03/03/2011",
"LastUpdateDate": "03/03/2011",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GILES",
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"AuthorizedOfficialMiddleName": "B",
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"AuthorizedOfficialCredential": "LPC",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Professional Counselor",
"LicenseNumber": "0701002197",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}