{
  "npi": "1295801678",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "MS, LPC, NCC",
    "authorized_official_first_name": "MARLA",
    "authorized_official_last_name": "UNDERWOOD",
    "authorized_official_middle_name": "H.",
    "authorized_official_name_prefix": "Ms.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "4178651646",
    "authorized_official_title_or_position": "Therapist",
    "enumeration_date": "2006-11-28",
    "last_updated": "2020-08-22",
    "organization_name": "BOYS & GIRLS TOWN OF MISSOURI",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "426 N ALEXANDER AVE",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "REPUBLIC",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "657381235",
      "state": "MO",
      "telephone_number": "417-732-2416"
    },
    {
      "address_1": "1212 W LOMBARD ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "SPRINGFIELD",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "658062720",
      "state": "MO",
      "telephone_number": "417-865-1646"
    }
  ],
  "taxonomies": [
    {
      "code": "323P00000X",
      "desc": "Psychiatric Residential Treatment Facility",
      "license": "002691",
      "primary": true,
      "state": "MO",
      "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 & Credentialed Psychiatric Residential Treatment Facility",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}