1245287630 NPI number — STEPHANIE CARROW L.C.S.W.

NPI Number: 1245287630
Health Care Provider/Practitioner: STEPHANIE CARROW L.C.S.W.

NPI Number : 1245287630 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245287630",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "X",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CARROW",
    "FirstName": "STEPHANIE",
    "MiddleName": null,
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "L.C.S.W.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "223 HUNYADI AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAIRFIELD",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06824-4119",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "917-613-6687",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "91 EAST AVE",
    "SecondLinePracticeLocationAddress": "STE 2",
    "PracticeLocationAddressCityName": "NORWALK",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06851-5020",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "917-613-6687",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/30/2006",
    "LastUpdateDate": "07/07/2021",
    "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": "006012",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "R052110-1",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}