1912146788 NPI number — LINDA MARION BRICKEL L.P.C., C.A.A.C.

NPI Number: 1912146788
Health Care Provider/Practitioner: LINDA MARION BRICKEL L.P.C., C.A.A.C.

NPI Number : 1912146788 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1912146788",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BRICKEL",
    "FirstName": "LINDA",
    "MiddleName": "MARION",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "L.P.C., C.A.A.C.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3075 S BRENNAN RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HEMLOCK",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48626-8750",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "989-233-5966",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "804 S HAMILTON ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAGINAW",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48602-1516",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "989-233-5966",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/18/2009",
    "LastUpdateDate": "02/18/2009",
    "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": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "C-00759",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "6401006560",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}