{
"Npi": {
"NPI": "1891841003",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RUSH CREEK COUNSELING CENTER",
"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": "2300 SW GREEN OAKS BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ARLINGTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76017-3708",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "187-468-7729",
"MailingAddressFaxNumber": "817-701-0379",
"FirstLinePracticeLocationAddress": "2300 SW GREEN OAKS BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ARLINGTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76017-3708",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "187-468-7729",
"PracticeLocationAddressFaxNumber": "817-701-0379",
"EnumerationDate": "01/28/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GOOD",
"AuthorizedOfficialFirstName": "SHARON",
"AuthorizedOfficialMiddleName": "LYNN",
"AuthorizedOfficialTitle": "DIRECTOR OF COUNSELING",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.A., L.P.C.",
"AuthorizedOfficialTelephoneNumber": "817-468-7729",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "15847",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"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."
}
}
}
}