{
"Npi": {
"NPI": "1871969600",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CREATIVE COUNSELING CENTER, PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "18 KENNEDY LANE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CONCORD",
"MailingAddressStateName": "NH",
"MailingAddressPostalCode": "03301",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "603-708-1438",
"MailingAddressFaxNumber": "888-287-5926",
"FirstLinePracticeLocationAddress": "18 KENNEDY LANE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CONCORD",
"PracticeLocationAddressStateName": "NH",
"PracticeLocationAddressPostalCode": "03301",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "603-708-1438",
"PracticeLocationAddressFaxNumber": "888-287-5926",
"EnumerationDate": "08/16/2015",
"LastUpdateDate": "06/19/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BEGIN",
"AuthorizedOfficialFirstName": "CHELSEA",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "CLINICIAN, MEMBER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCMHC",
"AuthorizedOfficialTelephoneNumber": "603-708-1438",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "997",
"LicenseNumberStateCode": "NH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "997",
"LicenseNumberStateCode": "NH",
"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."
},
{
"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."
}
]
}
}
}