{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "THE LISTENING RETREAT",
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"FirstName": null,
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"FirstLineMailingAddress": "1709 SCOTTSDALE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ARLINGTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76018-1868",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "305 REGENCY PKWY",
"SecondLinePracticeLocationAddress": "413",
"PracticeLocationAddressCityName": "MANSFIELD",
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"PracticeLocationAddressPostalCode": "76063-3794",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "682-292-8255",
"PracticeLocationAddressFaxNumber": "682-201-2225",
"EnumerationDate": "09/19/2016",
"LastUpdateDate": "09/19/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LONG",
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"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/LPC",
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"AuthorizedOfficialCredential": "LPC, LCDC",
"AuthorizedOfficialTelephoneNumber": "405-249-3386",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "72046",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}