{
"Npi": {
"NPI": "1861925364",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WALDRON AND ASSOCIATES 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": "4663 HAYGOOD RD",
"SecondLineMailingAddress": "BLDG 2 SUITE 216",
"MailingAddressCityName": "VIRGINIA BEACH",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23455-5442",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "804-641-5176",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4663 HAYGOOD RD",
"SecondLinePracticeLocationAddress": "BLDG 2 SUITE 216",
"PracticeLocationAddressCityName": "VIRGINIA BEACH",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23455-5442",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "804-641-5176",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/11/2017",
"LastUpdateDate": "04/11/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHILDRESS",
"AuthorizedOfficialFirstName": "TAMARA",
"AuthorizedOfficialMiddleName": "WALDRON",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "804-641-5176",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "0701005620",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}