{
"Npi": {
"NPI": "1114302601",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FLAHERTY",
"FirstName": "JENNIFER",
"MiddleName": "MAROLA",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PH.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MAROLA",
"OtherFirstName": "JENNIFER",
"OtherMiddleName": "ANN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PH.D.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 936",
"SecondLineMailingAddress": "EVMS MEDICAL GROUP",
"MailingAddressCityName": "NORFOLK",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23501-0936",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "757-446-8400",
"MailingAddressFaxNumber": "757-446-8401",
"FirstLinePracticeLocationAddress": "825 FAIRFAX AVE STE 710",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORFOLK",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23507-1914",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "757-446-5888",
"PracticeLocationAddressFaxNumber": "757-446-5918",
"EnumerationDate": "07/24/2015",
"LastUpdateDate": "12/29/2017",
"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": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "0810005254",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}