{"npi":"1679030084","type":"NPI-2","status":"active","name":{"display":"Integrated Life Counseling And Behavior Services","other":[],"organization_name":"INTEGRATED LIFE COUNSELING AND BEHAVIOR SERVICES","authorised_official":"Anacarolina Vaughn"},"specialty":{"primary_taxonomy":"101YM0800X","primary_taxonomy_description":"Mental Health Counselor","slug":"mental-health-counselor","schema_org_specialty":null,"all":[{"code":"101YM0800X","description":"Mental Health Counselor","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"200 WAYMONT CT STE 126-10","city":"LAKE MARY","state":"FL","postal_code":"327463413","country_code":"US","phone":"4074887927","fax":"4076030414"},{"purpose":"MAILING","street_1":"1175 2ND PL","city":"LONGWOOD","state":"FL","postal_code":"327503029","country_code":"US","phone":"3218481916"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"021251000","state":"FL","issuer":"39- MEDICAID"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2019-02-22","last_updated":"2021-10-20","_meta":{"source":"NPPES","snapshot_date":"2021-10-20","doc_url":"https://findmynpi.com/api"}}