{
"Npi": {
"NPI": "1861906364",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "THE THERAPY CONNECTION, LLC",
"ParentOrgTIN": null,
"OrgName": "THE THERAPY CONNECTION, 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": "10610 RHODE ISLAND AVE STE 204",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BELTSVILLE",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20705-2500",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-358-1128",
"MailingAddressFaxNumber": "301-476-4199",
"FirstLinePracticeLocationAddress": "10610 RHODE ISLAND AVE STE 204",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BELTSVILLE",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20705-2500",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-358-1128",
"PracticeLocationAddressFaxNumber": "301-476-4199",
"EnumerationDate": "11/21/2017",
"LastUpdateDate": "11/21/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOVELL",
"AuthorizedOfficialFirstName": "LESLEY-ANN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "COO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.ED. CCC-SLP",
"AuthorizedOfficialTelephoneNumber": "301-358-1128",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "17295",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103K00000X",
"TaxonomyName": "Behavior Analyst",
"LicenseNumber": "LBA248",
"LicenseNumberStateCode": "MD",
"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."
}
]
}
}
}