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1891075586 NPI number — CHELSEA BERNDL MADDOCK SHERRINGTON M.A., L.P.C.

NPI Number: 1891075586
Health Care Provider/Practitioner: CHELSEA BERNDL MADDOCK SHERRINGTON M.A., L.P.C.

Information about “1891075586” NPI (CHELSEA BERNDL MADDOCK SHERRINGTON M.A., L.P.C.) exists in 1891075586 in HTML format HTML  |  1891075586 in plain Text format TXT  |  1891075586 in PDF (Portable Document Format) PDF  |  1891075586 in an XML format XML  formats.

NPI Number : 1891075586 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1891075586",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MADDOCK SHERRINGTON",
    "FirstName": "CHELSEA",
    "MiddleName": "BERNDL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.A., L.P.C.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MADDOCK",
    "OtherFirstName": "CHELSEA",
    "OtherMiddleName": "BERNDL",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "205 W EUGENIE ST",
    "SecondLineMailingAddress": "UNIT H",
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60614-6067",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "312-480-5528",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "938 W NELSON ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHICAGO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60657-6704",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "773-296-3169",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/25/2011",
    "LastUpdateDate": "08/25/2011",
    "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": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "178007128",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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