{
"Npi": {
"NPI": "1861879439",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SPARROW CARE PSYCHOTHERAPY, 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": "1974 CAROLINA PLACE DR",
"SecondLineMailingAddress": "200A",
"MailingAddressCityName": "FORT MILL",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29708-6923",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "855-542-8255",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1974 CAROLINA PLACE DR",
"SecondLinePracticeLocationAddress": "200A",
"PracticeLocationAddressCityName": "FORT MILL",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29708-6923",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "855-542-8255",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/02/2015",
"LastUpdateDate": "05/02/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARTIN",
"AuthorizedOfficialFirstName": "SARA",
"AuthorizedOfficialMiddleName": "WILSON",
"AuthorizedOfficialTitle": "PSYCHOTHERAPIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MA LMFTI LMFTA",
"AuthorizedOfficialTelephoneNumber": "855-542-8255",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "5960",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}