{
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"FirstLineMailingAddress": "29 ORCHARD LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAMOINE",
"MailingAddressStateName": "ME",
"MailingAddressPostalCode": "04605-4464",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "207-667-1917",
"MailingAddressFaxNumber": "207-667-1814",
"FirstLinePracticeLocationAddress": "198 MAIN ST",
"SecondLinePracticeLocationAddress": "SUITE 9",
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"PracticeLocationAddressFaxNumber": "207-667-1814",
"EnumerationDate": "02/11/2010",
"LastUpdateDate": "02/11/2010",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BLAND",
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"AuthorizedOfficialMiddleName": "E.",
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"AuthorizedOfficialCredential": "LCSW",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Clinical Social Worker",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}