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1053123885 NPI number — JENNIFER BAUER SOVIK LMSW

NPI Number: 1053123885
Health Care Provider/Practitioner: JENNIFER BAUER SOVIK LMSW

Information about “1053123885” NPI (JENNIFER BAUER SOVIK LMSW) exists in 1053123885 in HTML format HTML  |  1053123885 in plain Text format TXT  |  1053123885 in PDF (Portable Document Format) PDF  |  1053123885 in an XML format XML  formats.

NPI Number : 1053123885 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053123885",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SOVIK",
    "FirstName": "JENNIFER",
    "MiddleName": "BAUER",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LMSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "902 W BROAD ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HORSEHEADS",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "14845-2254",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "607-200-3433",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "902 W BROAD ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HORSEHEADS",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "14845-2254",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "607-247-1442",
    "PracticeLocationAddressFaxNumber": "607-213-3154",
    "EnumerationDate": "01/20/2025",
    "LastUpdateDate": "01/20/2025",
    "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": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "104100000X",
          "TaxonomyName": "Social Worker",
          "LicenseNumber": "126348-01",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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