{
"Npi": {
"NPI": "1992616247",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BOUND & BALANCED, 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": "202 TRESTLEWOOD DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SUMMERVILLE",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29486-1824",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "810-434-1085",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1801 OLD TROLLEY RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SUMMERVILLE",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29485-8283",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "843-781-0075",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/15/2026",
"LastUpdateDate": "09/15/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LAENEN",
"AuthorizedOfficialFirstName": "EMILEE",
"AuthorizedOfficialMiddleName": "RAE",
"AuthorizedOfficialTitle": "PRACTICE OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPCA",
"AuthorizedOfficialTelephoneNumber": "810-434-1085",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
]
}
}
}