{
"Npi": {
"NPI": "1902282908",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CZG INC.",
"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": "PO BOX 1074",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOLDREGE",
"MailingAddressStateName": "NE",
"MailingAddressPostalCode": "68949-4074",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "308-991-3123",
"MailingAddressFaxNumber": "308-455-6242",
"FirstLinePracticeLocationAddress": "417 EAST AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOLDREGE",
"PracticeLocationAddressStateName": "NE",
"PracticeLocationAddressPostalCode": "68949-2216",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "308-991-3123",
"PracticeLocationAddressFaxNumber": "308-455-6242",
"EnumerationDate": "08/03/2015",
"LastUpdateDate": "04/26/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NICHOLS",
"AuthorizedOfficialFirstName": "CANDANCE",
"AuthorizedOfficialMiddleName": "LEA",
"AuthorizedOfficialTitle": "OWNER & THERAPIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LIMHP LMHP LPC LADC",
"AuthorizedOfficialTelephoneNumber": "308-991-3123",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "101Y00000X",
"TaxonomyName": "Counselor",
"LicenseNumber": "4230",
"LicenseNumberStateCode": "NE",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": "982",
"LicenseNumberStateCode": "NE",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "1117",
"LicenseNumberStateCode": "NE",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QM0855X",
"TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QR0405X",
"TaxonomyName": "Substance Use Disorder Rehabilitation Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QM0850X",
"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "2069",
"LicenseNumberStateCode": "NE",
"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."
},
{
"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."
}
]
}
}
}