{
"Npi": {
"NPI": "1932393907",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEIDE GRANT",
"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": "3605 NE LOOP 286",
"SecondLineMailingAddress": "STE 900",
"MailingAddressCityName": "PARIS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75460",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "903-715-8732",
"MailingAddressFaxNumber": "903-782-9082",
"FirstLinePracticeLocationAddress": "3605 NE LOOP 286",
"SecondLinePracticeLocationAddress": "STE 900",
"PracticeLocationAddressCityName": "PARIS",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75460",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "903-715-8732",
"PracticeLocationAddressFaxNumber": "903-782-9082",
"EnumerationDate": "08/31/2007",
"LastUpdateDate": "08/22/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GRANT",
"AuthorizedOfficialFirstName": "HEIDE",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "OWNER OPERATOR",
"AuthorizedOfficialNamePrefix": "MISS",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MS LPC",
"AuthorizedOfficialTelephoneNumber": "903-517-6101",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "18698",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}