{
"Npi": {
"NPI": "1003578782",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CARRONE",
"FirstName": "KELLY",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LCSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SCHROEDER",
"OtherFirstName": "KELLY",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1475 WESTERN AVE STE 51-3844",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALBANY",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "12203-3520",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "518-545-4475",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "404 ZENA RD STE 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WOODSTOCK",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "12498-2627",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "845-679-8650",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/09/2021",
"LastUpdateDate": "03/04/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "104100000X",
"TaxonomyName": "Social Worker",
"LicenseNumber": "101455",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}