{
  "npi": "1437636131",
  "enumeration_type": "NPI-2",
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    "authorized_official_credential": "LPCC, LADC",
    "authorized_official_first_name": "COACH",
    "authorized_official_last_name": "NAKUMBE",
    "authorized_official_telephone_number": "6122236622",
    "authorized_official_title_or_position": "Owner / Clinical Director",
    "enumeration_date": "2018-07-25",
    "last_updated": "2018-07-25",
    "organization_name": "779 RIVERSIDE RECOVERY & COUNSELING SERVICES",
    "organizational_subpart": "NO",
    "status": "A"
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    {
      "address_1": "8014 HIGHWAY 55 UNIT 197",
      "address_purpose": "MAILING",
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      "country_name": "United States",
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      "state": "MN",
      "telephone_number": "612-223-6622"
    },
    {
      "address_1": "4940 W 77TH ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "EDINA",
      "country_code": "US",
      "country_name": "United States",
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    }
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      "code": "101Y00000X",
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    },
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      "code": "101YP2500X",
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      "primary": false,
      "state": "MN",
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "103TB0200X",
      "desc": "Psychologist, Cognitive & Behavioral",
      "license": "00935",
      "primary": false,
      "state": "MN",
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    },
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      "license": "00935",
      "primary": false,
      "state": "MN",
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "103TP2701X",
      "desc": "Psychologist, Group Psychotherapy",
      "license": "00935",
      "primary": false,
      "state": "MN",
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "261QM0850X",
      "desc": "Clinic/Center, Adult Mental Health",
      "license": "00935",
      "primary": false,
      "state": "MN",
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    },
    {
      "code": "261QM0855X",
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      "license": "00935",
      "primary": false,
      "state": "MN",
      "taxonomy_group": ""
    },
    {
      "code": "101YA0400X",
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      "license": "303344",
      "primary": true,
      "state": "MN",
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    }
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    "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 Counselor, Addiction (Substance Use Disorder)",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}