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1073618609 NPI number — MARINA DEMENECH LCSW

NPI Number: 1073618609
Health Care Provider/Practitioner: MARINA DEMENECH LCSW

Information about “1073618609” NPI (MARINA DEMENECH LCSW) exists in 1073618609 in HTML format HTML  |  1073618609 in plain Text format TXT  |  1073618609 in PDF (Portable Document Format) PDF  |  1073618609 in an XML format XML  formats.

NPI Number : 1073618609 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1073618609",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DEMENECH",
    "FirstName": "MARINA",
    "MiddleName": null,
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "DEMENECH SANDERSON",
    "OtherFirstName": "MARINA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LCSW",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "844 E GORHAM ST",
    "SecondLineMailingAddress": "APT 1",
    "MailingAddressCityName": "MADISON",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "53703-1790",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "646-388-1498",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "406 N PINCKNEY ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MADISON",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "53703-1410",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "646-388-1498",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/14/2006",
    "LastUpdateDate": "09/17/2013",
    "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": "071639",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "8030-123",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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