{
"Npi": {
"NPI": "1134502123",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WHITE",
"FirstName": "JESSICA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LISW,LICSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "TUCKER LISW,LICSW",
"OtherFirstName": "JESSICA",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "TUCKER",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "402 FRONT ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MARIETTA",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45750-2124",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "740-434-3060",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "402 FRONT ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MARIETTA",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45750-2124",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "740-629-4300",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/08/2015",
"LastUpdateDate": "03/23/2025",
"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": "104100000X",
"TaxonomyName": "Social Worker",
"LicenseNumber": "I.2102687",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "104100000X",
"TaxonomyName": "Social Worker",
"LicenseNumber": "AP00944679",
"LicenseNumberStateCode": "WV",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "I.2102687",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}