{
"Npi": {
"NPI": "1083148431",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NINA M. KALCKAR, LCSW",
"LastName": null,
"FirstName": null,
"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 1496",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KAMUELA",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96743-1496",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "617-899-4923",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "65-1206 MAMALAHOA HWY",
"SecondLinePracticeLocationAddress": "BLD 2-2",
"PracticeLocationAddressCityName": "KAMUELA",
"PracticeLocationAddressStateName": "HI",
"PracticeLocationAddressPostalCode": "96743-7303",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "808-333-2567",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/12/2017",
"LastUpdateDate": "04/12/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KALCKAR",
"AuthorizedOfficialFirstName": "NINA",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "LCSW/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCSW",
"AuthorizedOfficialTelephoneNumber": "617-899-4923",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "4034",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}