{
"Npi": {
"NPI": "1861375420",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "THE FOUNDATION FOR COMMUNITY HEALTH AND WELLNESS",
"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": "675 CALHOUN AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BEAUMONT",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77707-1169",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "409-673-4715",
"MailingAddressFaxNumber": "409-673-4715",
"FirstLinePracticeLocationAddress": "2365 IH 10 E STE 4",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BEAUMONT",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77702-1344",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "409-673-4715",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/30/2025",
"LastUpdateDate": "07/30/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HILLIARD",
"AuthorizedOfficialFirstName": "MELBA",
"AuthorizedOfficialMiddleName": "THOMAS",
"AuthorizedOfficialTitle": "OWNER/THERAPIST",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "409-673-4715",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"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."
}
]
}
}
}