{"npi":"1992467963","type":"NPI-2","status":"active","name":{"display":"Provo Counseling Center","other":[],"organization_name":"PROVO COUNSELING CENTER","authorised_official":"Cory Dennis"},"specialty":{"primary_taxonomy":"1041C0700X","primary_taxonomy_description":"Clinical Social Worker","slug":"clinical-social-worker","schema_org_specialty":null,"all":[{"code":"101YM0800X","description":"Mental Health Counselor","primary":false,"state":null,"license":null},{"code":"1041C0700X","description":"Clinical Social Worker","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"3325 N UNIVERSITY AVE STE 300","city":"PROVO","state":"UT","postal_code":"846047412","country_code":"US","phone":"8014727134","fax":"8017437599"},{"purpose":"MAILING","street_1":"3325 N UNIVERSITY AVE STE 300","city":"PROVO","state":"UT","postal_code":"846047412","country_code":"US","phone":"8014727134","fax":"8017437599"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"1992467963","state":"UT","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2021-10-07","last_updated":"2023-08-25","_meta":{"source":"NPPES","snapshot_date":"2023-08-25","doc_url":"https://findmynpi.com/api"}}