{
"Npi": {
"NPI": "1881922995",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "EVANS",
"FirstName": "KIMBERLY",
"MiddleName": "HINTON",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "MA, ED.M, LPC, NCC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1310 RAEFORD ROAD",
"SecondLineMailingAddress": "SUITE 3",
"MailingAddressCityName": "FAYETTEVILLE",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28305-5086",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "910-920-0572",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1310 RAEFORD RD",
"SecondLinePracticeLocationAddress": "SUITE 3",
"PracticeLocationAddressCityName": "FAYETTEVILLE",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28305-5085",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "910-920-0572",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/01/2009",
"LastUpdateDate": "03/22/2012",
"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": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "LH00011168",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "7541",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}