{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "WEST SIDE PSYCHOTHERAPY, LCSW, P.C.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "201 W 94TH ST",
"SecondLineMailingAddress": "3A",
"MailingAddressCityName": "NEW YORK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10025-6938",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "646-350-3182",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "350 CENTRAL PARK W",
"SecondLinePracticeLocationAddress": "SUITE 1A",
"PracticeLocationAddressCityName": "NEW YORK",
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"PracticeLocationAddressPostalCode": "10025-6547",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "646-250-3182",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/12/2013",
"LastUpdateDate": "07/12/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROGAN",
"AuthorizedOfficialFirstName": "MICHAEL",
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"AuthorizedOfficialTitle": "VICE PRESIDENT/THERAPIST",
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"AuthorizedOfficialCredential": "LMSW",
"AuthorizedOfficialTelephoneNumber": "646-250-3182",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "054990-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}