{
"Npi": {
"NPI": "1215294954",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BADER-ANDERSON",
"FirstName": "DIANE",
"MiddleName": "ROBIN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "SW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4642 PINE GREEN TRL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SARASOTA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34241-6247",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "941-915-1594",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4642 PINE GREEN TRL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SARASOTA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34241-6247",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "941-915-1594",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/19/2012",
"LastUpdateDate": "04/07/2023",
"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": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "44SC06078800",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}