{
"Npi": {
"NPI": "1952215634",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "METAVIA LLC",
"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": "159 TRAIL CREEK LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAVANNAH",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31405-8157",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "234-303-9785",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "159 TRAIL CREEK LN",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAVANNAH",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "31405-8157",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "234-303-9785",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/30/2026",
"LastUpdateDate": "09/30/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HEPWORTH",
"AuthorizedOfficialFirstName": "ENGELA",
"AuthorizedOfficialMiddleName": "GERTRUIDA",
"AuthorizedOfficialTitle": "PSYCHOTHERAPIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCSW",
"AuthorizedOfficialTelephoneNumber": "234-303-9785",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": null,
"LicenseNumberStateCode": "NULL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}