{
"Npi": {
"NPI": "1932386802",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MASON",
"FirstName": "BRENDA",
"MiddleName": "ANN",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LCPC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1317 FLAGG RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DIXON",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "61021-8949",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "815-677-6650",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "747 E ETNA RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OTTAWA",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "61350-3777",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "815-993-1614",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/23/2008",
"LastUpdateDate": "09/20/2016",
"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": "26644",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": "180.010067",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}