{
"Npi": {
"NPI": "1215252614",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DIANA DIGIACOMO-CANELLAS,LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6 FREEMAN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HARTFORD",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06114-2719",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "860-324-6841",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "705 N MOUNTAIN RD",
"SecondLinePracticeLocationAddress": "SUITE 110",
"PracticeLocationAddressCityName": "NEWINGTON",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06111-1412",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "860-324-6841",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/30/2010",
"LastUpdateDate": "03/30/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DIGIACOMO-CANELLAS",
"AuthorizedOfficialFirstName": "DIANA",
"AuthorizedOfficialMiddleName": "SILVIA",
"AuthorizedOfficialTitle": "CLINICAL SOCIAL WORKER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCSW",
"AuthorizedOfficialTelephoneNumber": "860-324-6841",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "006422",
"LicenseNumberStateCode": "CT",
"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."
}
}
}
}