{"npi":"1003909664","type":"NPI-1","status":"active","name":{"display":"Raven Ellis Lcpc","other":[{"code":"5","type":"Also known as","value":"ELLIS-TAYLOR, RAVEN KETURAH"}],"first":"RAVEN","last":"ELLIS","middle":"KETURAH","credential":"LCPC"},"specialty":{"primary_taxonomy":"101YP2500X","primary_taxonomy_description":"Professional Counselor","slug":"professional-counselor","schema_org_specialty":null,"all":[{"code":"101YP2500X","description":"Professional Counselor","primary":true,"state":"MD","license":"LC1921"}]},"addresses":[{"purpose":"LOCATION","street_1":"3525 RESOURCE DRIVE ROOM C47","city":"RANDALLSTOWN","state":"MD","postal_code":"21133","country_code":"US","phone":"4106557655","fax":"4106553941"},{"purpose":"MAILING","street_1":"10400 RIDGELAND ROAD STE 1","city":"COCKEYSVILLE","state":"MD","postal_code":"21030","country_code":"US","phone":"4106286120","fax":"4106289825"}],"license":{"state":"MD","number":"LC1921"},"identifiers":[{"type_code":"01","label":"Other","value":"251690","state":null,"issuer":"COMPSYCH"},{"type_code":"01","label":"Other","value":"64558301","state":null,"issuer":"CAREFIRST MD"},{"type_code":"01","label":"Other","value":"R5830050","state":null,"issuer":"CAREFIRST EHMSI"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-10-02","last_updated":"2007-07-08","_meta":{"source":"NPPES","snapshot_date":"2007-07-08","doc_url":"https://findmynpi.com/api"}}