1023442522 NPI number — KATHERINE R SMALLER PHD, L.C.S.W., M.ED.

NPI Number: 1023442522
Health Care Provider/Practitioner: KATHERINE R SMALLER PHD, L.C.S.W., M.ED.

NPI Number : 1023442522 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1023442522",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SMALLER",
    "FirstName": "KATHERINE",
    "MiddleName": "R",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PHD, L.C.S.W., M.ED.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 93",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DOUGLAS",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "49406-0093",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "45 BLUE STAR HWY STE E",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DOUGLAS",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "49406-5139",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "312-771-9826",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/03/2013",
    "LastUpdateDate": "08/07/2020",
    "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": "149.015824",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "6801097474",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}