{
  "npi": "1891374930",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "LICDC-CS, LSW",
    "authorized_official_first_name": "MELISSA",
    "authorized_official_last_name": "TESTER",
    "authorized_official_middle_name": "ANN",
    "authorized_official_name_prefix": "Mrs.",
    "authorized_official_telephone_number": "5672012048",
    "authorized_official_title_or_position": "Owner/Executive Director",
    "certification_date": "2021-04-06",
    "enumeration_date": "2021-04-06",
    "last_updated": "2021-04-06",
    "organization_name": "BEACON BEHAVIORAL HEALTH SERVICES",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "114 N WOOD ST",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "FREMONT",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "434202440",
      "state": "OH",
      "telephone_number": "567-201-2048"
    },
    {
      "address_1": "114 N WOOD ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "FREMONT",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "567-280-4395",
      "postal_code": "434202440",
      "state": "OH",
      "telephone_number": "567-201-2048"
    }
  ],
  "taxonomies": [
    {
      "code": "251S00000X",
      "desc": "Community/Behavioral Health",
      "license": null,
      "primary": true,
      "state": null,
      "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 Community/Behavioral Health",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}