{
"Npi": {
"NPI": "1962863449",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CATOMA COUNSELING SERVICES LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "817 GROGAN ST",
"SecondLineMailingAddress": "SUITE 105",
"MailingAddressCityName": "LAVONIA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30553-1875",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "706-356-0333",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "817 GROGAN ST",
"SecondLinePracticeLocationAddress": "SUITE 105",
"PracticeLocationAddressCityName": "LAVONIA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30553-1875",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "706-356-0333",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/11/2016",
"LastUpdateDate": "03/11/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GIBSON",
"AuthorizedOfficialFirstName": "JOEL",
"AuthorizedOfficialMiddleName": "HERMAN",
"AuthorizedOfficialTitle": "SENIOR PARTNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "M.ED., LPC",
"AuthorizedOfficialTelephoneNumber": "706-356-0333",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "LPC008396",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}