{
"Npi": {
"NPI": "1912130576",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DEBRA T. SEGAL COUNSELING, P.A.",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
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"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "65 3RD ST NW",
"SecondLineMailingAddress": "SUITE 210",
"MailingAddressCityName": "WINTER HAVEN",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33881-4670",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "863-299-2202",
"MailingAddressFaxNumber": "863-299-9661",
"FirstLinePracticeLocationAddress": "65 3RD ST NW",
"SecondLinePracticeLocationAddress": "SUITE 210",
"PracticeLocationAddressCityName": "WINTER HAVEN",
"PracticeLocationAddressStateName": "FL",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "863-299-2202",
"PracticeLocationAddressFaxNumber": "863-299-9661",
"EnumerationDate": "08/31/2009",
"LastUpdateDate": "11/12/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SEGAL",
"AuthorizedOfficialFirstName": "DEBRA",
"AuthorizedOfficialMiddleName": "T",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "863-299-2202",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "SW528",
"LicenseNumberStateCode": "FL",
"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."
}
}
}
}