{
"Npi": {
"NPI": "1194242792",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "AYERS",
"FirstName": "DAPHNE",
"MiddleName": "CHRISTINE",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "LISW-S, LICDC-CS, GA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "246 NORTHLAND DR STE 200A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MEDINA",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44256-3440",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "330-764-3659",
"MailingAddressFaxNumber": "330-764-8126",
"FirstLinePracticeLocationAddress": "246 NORTHLAND DR STE 200A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MEDINA",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44256-3440",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "330-764-3659",
"PracticeLocationAddressFaxNumber": "330-764-8126",
"EnumerationDate": "08/24/2017",
"LastUpdateDate": "10/18/2024",
"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": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": "161376",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "104100000X",
"TaxonomyName": "Social Worker",
"LicenseNumber": "S1700154",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "175T00000X",
"TaxonomyName": "Peer Specialist",
"LicenseNumber": null,
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "I.2204124",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}