{
"Npi": {
"NPI": "1851839419",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SIMON",
"FirstName": "CASEY",
"MiddleName": "J.",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "M.S., LMFT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1800 BRIDGEGATE STREET",
"SecondLineMailingAddress": "SUITE #108",
"MailingAddressCityName": "WESTLAKE VILLAGE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91361",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "805-402-9385",
"MailingAddressFaxNumber": "805-267-9692",
"FirstLinePracticeLocationAddress": "1800 BRIDGEGATE STREET",
"SecondLinePracticeLocationAddress": "SUITE #108",
"PracticeLocationAddressCityName": "WESTLAKE VILLAGE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91361",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "805-402-9385",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/03/2017",
"LastUpdateDate": "10/19/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "102L00000X",
"TaxonomyName": "Psychoanalyst",
"LicenseNumber": "MFT97789",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MFT97789",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "MFT97789",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101Y00000X",
"TaxonomyName": "Counselor",
"LicenseNumber": "MFT97789",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}