{
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"OrgName": "HOLLY CAMPIDILLI, MSSW, LMSW-IPR",
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"FirstLineMailingAddress": "123 MARY JON DRIVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "AMARILLO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "79119",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "806-672-3497",
"MailingAddressFaxNumber": "806-322-1554",
"FirstLinePracticeLocationAddress": "123 MARY JON DR",
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"PracticeLocationAddressCityName": "AMARILLO",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "806-672-3497",
"PracticeLocationAddressFaxNumber": "806-322-1554",
"EnumerationDate": "06/07/2010",
"LastUpdateDate": "06/07/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CAMPIDILLI",
"AuthorizedOfficialFirstName": "HOLLY",
"AuthorizedOfficialMiddleName": "RAE",
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"AuthorizedOfficialCredential": "MSSW, LMSW-IPR",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "104100000X",
"TaxonomyName": "Social Worker",
"LicenseNumber": "32354",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}