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1124855671 NPI number — ANNA MUMFORD LICSW

NPI Number: 1124855671
Health Care Provider/Practitioner: ANNA MUMFORD LICSW

Information about “1124855671” NPI (ANNA MUMFORD LICSW) exists in 1124855671 in HTML format HTML  |  1124855671 in plain Text format TXT  |  1124855671 in PDF (Portable Document Format) PDF  |  1124855671 in an XML format XML  formats.

NPI Number : 1124855671 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124855671",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MUMFORD",
    "FirstName": "ANNA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LICSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 4009",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BURLINGTON",
    "MailingAddressStateName": "VT",
    "MailingAddressPostalCode": "05406-4009",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "802-557-1939",
    "MailingAddressFaxNumber": "802-488-3711",
    "FirstLinePracticeLocationAddress": "50 JOY DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SOUTH BURLINGTON",
    "PracticeLocationAddressStateName": "VT",
    "PracticeLocationAddressPostalCode": "05403-6118",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "802-557-1939",
    "PracticeLocationAddressFaxNumber": "802-861-6460",
    "EnumerationDate": "09/18/2024",
    "LastUpdateDate": "09/18/2024",
    "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": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "089.0132506",
        "LicenseNumberStateCode": "VT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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