NPI Code Detail JSON Logo

1962657585 NPI number — FOR THE CAUSE STI AWARENESS CHARITY, INC.

NPI Number: 1962657585
Health Care Provider/Practitioner: FOR THE CAUSE STI AWARENESS CHARITY, INC.

Information about “1962657585” NPI (FOR THE CAUSE STI AWARENESS CHARITY, INC.) exists in 1962657585 in HTML format HTML  |  1962657585 in plain Text format TXT  |  1962657585 in PDF (Portable Document Format) PDF  |  1962657585 in an XML format XML  formats.

NPI Number : 1962657585 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962657585",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "FOR THE CAUSE STI AWARENESS CHARITY, INC.",
    "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": "2200 HASSELL RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HOFFMAN ESTATES",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60169-2148",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "847-802-8133",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2200 HASSELL RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOFFMAN ESTATES",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60169-2148",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "847-802-8133",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/24/2008",
    "LastUpdateDate": "07/08/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "COLEMAN",
    "AuthorizedOfficialFirstName": "OCTAVIA",
    "AuthorizedOfficialMiddleName": "JARE'L",
    "AuthorizedOfficialTitle": "FOUNDER/COUNSELOR",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MHSA",
    "AuthorizedOfficialTelephoneNumber": "919-455-3740",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "1085631",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "305S00000X",
          "TaxonomyName": "Point of Service",
          "LicenseNumber": "45175811",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "302R00000X",
          "TaxonomyName": "Health Maintenance Organization",
          "LicenseNumber": "45175811",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
          "LicenseNumber": "45175811",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "45175811",
          "LicenseNumberStateCode": "IL",
          "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."
        },
        {
          "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."
        }
      ]
    }
  }
}
                
            

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