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1023365756 NPI number — CAROLYN A. SOUDERS LCSW

NPI Number: 1023365756
Health Care Provider/Practitioner: CAROLYN A. SOUDERS LCSW

Information about “1023365756” NPI (CAROLYN A. SOUDERS LCSW) exists in 1023365756 in HTML format HTML  |  1023365756 in plain Text format TXT  |  1023365756 in PDF (Portable Document Format) PDF  |  1023365756 in an XML format XML  formats.

NPI Number : 1023365756 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1023365756",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SOUDERS",
    "FirstName": "CAROLYN",
    "MiddleName": "A.",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KRAUS",
    "OtherFirstName": "CAROLYN",
    "OtherMiddleName": "A.",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2500 NESHAMINY INTERPLEX DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TREVOSE",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "19053-6943",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "267-991-7666",
    "MailingAddressFaxNumber": "267-991-7615",
    "FirstLinePracticeLocationAddress": "13815 PROFESSIONAL CENTER DR STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HUNTERSVILLE",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28078-7951",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "704-384-1320",
    "PracticeLocationAddressFaxNumber": "704-316-3138",
    "EnumerationDate": "08/13/2012",
    "LastUpdateDate": "10/26/2020",
    "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": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "CW017257",
        "LicenseNumberStateCode": "PA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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