{
"Npi": {
"NPI": "1043041981",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "AGUIRRE",
"FirstName": "TESLA",
"MiddleName": "RAE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "AGUIRRE",
"OtherFirstName": "TESLA",
"OtherMiddleName": "RAE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "LBSW",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "401 E LANCE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SILVER CITY",
"MailingAddressStateName": "NM",
"MailingAddressPostalCode": "88061-6628",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "575-680-0584",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4042 NM-90",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SILVER CITY",
"PracticeLocationAddressStateName": "NM",
"PracticeLocationAddressPostalCode": "88061",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "575-956-2170",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/12/2024",
"LastUpdateDate": "08/29/2024",
"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": "1041S0200X",
"TaxonomyName": "School Social Worker",
"LicenseNumber": "SWB-2024-0573",
"LicenseNumberStateCode": "NM",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}