{
"Npi": {
"NPI": "1043022577",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WOODWARD",
"FirstName": "MATTHEW",
"MiddleName": "T",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LCSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "25 STOCKER AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LYNN",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "01904-1226",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "781-913-9280",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "50 DUNHAM RIDGE ROAD",
"SecondLinePracticeLocationAddress": "SUITE 3200-3350",
"PracticeLocationAddressCityName": "BEVERLY",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "01915",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "978-600-0816",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/22/2025",
"LastUpdateDate": "01/22/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "104100000X",
"TaxonomyName": "Social Worker",
"LicenseNumber": "LCSW230836",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}