{
  "npi": "1225155393",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "JACKIE",
    "authorized_official_last_name": "MAURER",
    "authorized_official_middle_name": "J",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "7153497069",
    "authorized_official_title_or_position": "Office Supervisor",
    "certification_date": "2022-08-15",
    "enumeration_date": "2007-03-23",
    "last_updated": "2022-08-15",
    "organization_name": "NORTHWEST COUNSELING & GUIDANCE CLINIC",
    "organizational_subpart": "YES",
    "parent_organization_legal_business_name": "NORTHWEST COUNSELING & GUIDANCE CLINIC",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1119 W KENNEDY AVE",
      "address_2": "STE A",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "KIMBERLY",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "888-625-8634",
      "postal_code": "541362213",
      "state": "WI",
      "telephone_number": "920-364-9668"
    },
    {
      "address_1": "PO BOX 309",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "SIREN",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "888-625-8634",
      "postal_code": "548720309",
      "state": "WI",
      "telephone_number": "715-349-7069"
    }
  ],
  "taxonomies": [
    {
      "code": "261QM0855X",
      "desc": "Clinic/Center, Adolescent and Children Mental Health",
      "license": "2160",
      "primary": true,
      "state": "WI",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center",
    "certifying_board": "Accreditation Association for Ambulatory Health Care (AAAHC) / CMS",
    "cms_medicare_crosswalk": []
  }
}