{
  "npi": "1346697208",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "PHD",
    "authorized_official_first_name": "GWENDOLYN",
    "authorized_official_last_name": "KIMBROUGH",
    "authorized_official_middle_name": "LOVE",
    "authorized_official_name_prefix": "Dr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "2028082878",
    "authorized_official_title_or_position": "CEO",
    "certification_date": "2024-11-05",
    "enumeration_date": "2016-05-20",
    "last_updated": "2024-11-05",
    "organization_name": "1 AXIUM, LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "taxonomies": [
    {
      "code": "101YM0800X",
      "desc": "Counselor, Mental Health",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "101YP2500X",
      "desc": "Counselor, Professional",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "103K00000X",
      "desc": "Behavior Analyst",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "103TC0700X",
      "desc": "Psychologist, Clinical",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "103TP2701X",
      "desc": "Psychologist, Group Psychotherapy",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "103TR0400X",
      "desc": "Psychologist, Rehabilitation",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "1041C0700X",
      "desc": "Social Worker, Clinical",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "106H00000X",
      "desc": "Marriage & Family Therapist",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "235Z00000X",
      "desc": "Speech-Language Pathologist,  ",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "251B00000X",
      "desc": "Case Management",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "251C00000X",
      "desc": "Day Training, Developmentally Disabled Services",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "251E00000X",
      "desc": "Home Health",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "251S00000X",
      "desc": "Community/Behavioral Health",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "253Z00000X",
      "desc": "In Home Supportive Care",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "385H00000X",
      "desc": "Respite Care",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    }
  ],
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Community/Behavioral Health",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "common_medicare_procedures": [
      "Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)",
      "Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination",
      "Preventive Screening, Patient Counseling & Multidisciplinary Referral"
    ],
    "common_part_d_therapeutic_classes": [
      "Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)"
    ]
  }
}