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1033822259 NPI number — MICHELLE WASIUK

NPI Number: 1033822259
Health Care Provider/Practitioner: MICHELLE WASIUK

Information about “1033822259” NPI (MICHELLE WASIUK) exists in 1033822259 in HTML format HTML  |  1033822259 in plain Text format TXT  |  1033822259 in PDF (Portable Document Format) PDF  |  1033822259 in an XML format XML  formats.

NPI Number : 1033822259 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033822259",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WASIUK",
    "FirstName": "MICHELLE",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 321",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EAST DERRY",
    "MailingAddressStateName": "NH",
    "MailingAddressPostalCode": "03041-0321",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "978-254-1124",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1 TARA BLVD STE 200",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NASHUA",
    "PracticeLocationAddressStateName": "NH",
    "PracticeLocationAddressPostalCode": "03062-2809",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "603-242-2296",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/03/2023",
    "LastUpdateDate": "01/03/2023",
    "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": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "11961",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "2527",
          "LicenseNumberStateCode": "NH",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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