{
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"FirstLineMailingAddress": "11162 42ND RD N",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROYAL PALM BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33411-9113",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "561-790-6940",
"FirstLinePracticeLocationAddress": "200 KNUTH RD",
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"PracticeLocationAddressCityName": "BOYNTON BEACH",
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"PracticeLocationAddressFaxNumber": "561-790-6940",
"EnumerationDate": "12/01/2014",
"LastUpdateDate": "12/01/2014",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GOULD",
"AuthorizedOfficialFirstName": "MARGARET",
"AuthorizedOfficialMiddleName": "PATRICE",
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"AuthorizedOfficialCredential": "L.C.S.W.",
"AuthorizedOfficialTelephoneNumber": "561-736-2550",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "SW2600",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}