{
"Npi": {
"NPI": "1154995462",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VITALE-SANTANA",
"FirstName": "SARAH",
"MiddleName": "ROSE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PSYD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "VITALE",
"OtherFirstName": "SARAH",
"OtherMiddleName": "ROSE",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "PSYD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "3333 BURNET AVE # MLC4002",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CINCINNATI",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45229-3026",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "513-636-4611",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3333 BURNET AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CINCINNATI",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45229-3026",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "586-747-7416",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/20/2021",
"LastUpdateDate": "06/13/2025",
"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": "103TC2200X",
"TaxonomyName": "Clinical Child & Adolescent Psychologist",
"LicenseNumber": "P.08319",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}