{
"Npi": {
"NPI": "1871160002",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "THOMAS",
"FirstName": "COURTLYN",
"MiddleName": "LEE",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "LBA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "103 PENNWOOD DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HAMPTON",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23666-3810",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "610-529-1927",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "522 S INDEPENDENCE BLVD STE 102D",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VIRGINIA BEACH",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23452-1149",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "610-529-1927",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/07/2021",
"LastUpdateDate": "06/07/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103K00000X",
"TaxonomyName": "Behavior Analyst",
"LicenseNumber": "0133001968",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}