NPI Code Detail JSON Logo

1972005833 NPI number — CENTER FOR LEARNING AND GROWTH HEALTH AND WELLNESS SERVICES, LLC

NPI Number: 1972005833
Health Care Provider/Practitioner: CENTER FOR LEARNING AND GROWTH HEALTH AND WELLNESS SERVICES, LLC

Information about “1972005833” NPI (CENTER FOR LEARNING AND GROWTH HEALTH AND WELLNESS SERVICES, LLC) exists in 1972005833 in HTML format HTML  |  1972005833 in plain Text format TXT  |  1972005833 in PDF (Portable Document Format) PDF  |  1972005833 in an XML format XML  formats.

NPI Number : 1972005833 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1972005833",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CENTER FOR LEARNING AND GROWTH HEALTH AND WELLNESS 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": "14101 68TH DR FL 1",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FLUSHING",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11367-1635",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "718-551-1868",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "14101 68TH DR FL 1",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FLUSHING",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11367-1635",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "718-551-1868",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/06/2018",
    "LastUpdateDate": "03/06/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BRIGNOLO",
    "AuthorizedOfficialFirstName": "LUIS",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "COUNSELOR",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LMHC",
    "AuthorizedOfficialTelephoneNumber": "718-551-1868",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225700000X",
          "TaxonomyName": "Massage Therapist",
          "LicenseNumber": "027228",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "008172",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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