{
"Npi": {
"NPI": "1861781676",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ZAVASKY",
"FirstName": "DAVID",
"MiddleName": "J",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2906 TREESIDE ST NW",
"SecondLineMailingAddress": "APT A",
"MailingAddressCityName": "CANTON",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44709-1957",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "330-478-4543",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "625 CLEVELAND AVE NW",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CANTON",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44702-1805",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "330-455-0374",
"PracticeLocationAddressFaxNumber": "330-455-2101",
"EnumerationDate": "04/01/2011",
"LastUpdateDate": "04/01/2011",
"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": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "900624",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}