{
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"IsOrgSubpart": "N",
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"FirstLineMailingAddress": "2292 SOUTHGATE DR SE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GRAND RAPIDS",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49508-0949",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "734-846-8241",
"MailingAddressFaxNumber": "888-398-2113",
"FirstLinePracticeLocationAddress": "41 WASHINGTON AVE",
"SecondLinePracticeLocationAddress": "SUITE 368",
"PracticeLocationAddressCityName": "GRAND HAVEN",
"PracticeLocationAddressStateName": "MI",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "734-846-8241",
"PracticeLocationAddressFaxNumber": "888-398-2113",
"EnumerationDate": "10/24/2012",
"LastUpdateDate": "10/17/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "YOUMANS",
"AuthorizedOfficialFirstName": "LINDA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "734-846-8241",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "6401007781",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"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."
}
}
}
}