{
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"FirstLineMailingAddress": "5610 RAPID BROOK CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KINGWOOD",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77345-1922",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "832-442-3012",
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"EnumerationDate": "02/14/2012",
"LastUpdateDate": "03/19/2013",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JACOBS",
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"AuthorizedOfficialCredential": "LPC",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Professional Counselor",
"LicenseNumber": "64668",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}