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1154471076 NPI number — MARY PATRICIA LEVIS MSW,LCSW

NPI Number: 1154471076
Health Care Provider/Practitioner: MARY PATRICIA LEVIS MSW,LCSW

Information about “1154471076” NPI (MARY PATRICIA LEVIS MSW,LCSW) exists in 1154471076 in HTML format HTML  |  1154471076 in plain Text format TXT  |  1154471076 in PDF (Portable Document Format) PDF  |  1154471076 in an XML format XML  formats.

NPI Number : 1154471076 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1154471076",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LEVIS",
    "FirstName": "MARY",
    "MiddleName": "PATRICIA",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MSW,LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 1083",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FRAZIER PARK",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "93225-1083",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "661-245-2617",
    "MailingAddressFaxNumber": "661-245-3181",
    "FirstLinePracticeLocationAddress": "705 SAN EMIDIO WAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FRAZIER PARK",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "93225",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "661-245-2617",
    "PracticeLocationAddressFaxNumber": "661-245-3181",
    "EnumerationDate": "01/11/2007",
    "LastUpdateDate": "07/08/2007",
    "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": "22915",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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