{
"Npi": {
"NPI": "1225696743",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FROSTAD",
"FirstName": "AMANDA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LCSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "324 COUNTY ROUTE 51 BLDG 1",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MALONE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "12953-4502",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "315-376-5450",
"MailingAddressFaxNumber": "315-779-5028",
"FirstLinePracticeLocationAddress": "650 STATE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WATERTOWN",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "13601-2839",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "315-755-1251",
"PracticeLocationAddressFaxNumber": "315-291-6601",
"EnumerationDate": "05/30/2019",
"LastUpdateDate": "04/04/2025",
"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": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "104100000X",
"TaxonomyName": "Social Worker",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "097748",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}