{
"Npi": {
"NPI": "1912563297",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HUMPHRIES",
"FirstName": "GARRETT",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.A",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "400 S JEFFERSON ST STE 114",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SPOKANE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "99204-3100",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "509-850-0662",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "400 S JEFFERSON ST STE 114",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SPOKANE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "99204-3100",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "509-850-0662",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/13/2019",
"LastUpdateDate": "10/13/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "MC61361608",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "171M00000X",
"TaxonomyName": "Case Manager/Care Coordinator",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MG61354283",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}