{
  "npi": "1275650350",
  "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": "7153274322",
    "authorized_official_title_or_position": "Billing Office Supervisor",
    "enumeration_date": "2007-03-23",
    "last_updated": "2015-11-23",
    "organization_name": "NORTHWEST COUNSELING & GUIDANCE CLINIC",
    "organizational_subpart": "YES",
    "parent_organization_legal_business_name": "NORTHWEST COUNSELING AND GUIDANCE CLINIC",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "203 UNITED WAY",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "FREDERIC",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "715-327-8509",
      "postal_code": "548378938",
      "state": "WI",
      "telephone_number": "715-327-4322"
    },
    {
      "address_1": "5655 N. 28TH AVE",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "WAUSAU",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "715-675-0545",
      "postal_code": "544019709",
      "state": "WI",
      "telephone_number": "715-675-5454"
    }
  ],
  "taxonomies": [
    {
      "code": "261QM0855X",
      "desc": "Clinic/Center, Adolescent and Children Mental Health",
      "license": "2404",
      "primary": false,
      "state": "WI",
      "taxonomy_group": ""
    },
    {
      "code": "261QM0855X",
      "desc": "Clinic/Center, Adolescent and Children Mental Health",
      "license": null,
      "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": []
  }
}