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1326068610 NPI number — MONICA BRIDGET LAZERE LCSW LMFT

NPI Number: 1326068610
Health Care Provider/Practitioner: MONICA BRIDGET LAZERE LCSW LMFT

Information about “1326068610” NPI (MONICA BRIDGET LAZERE LCSW LMFT) exists in 1326068610 in HTML format HTML  |  1326068610 in plain Text format TXT  |  1326068610 in PDF (Portable Document Format) PDF  |  1326068610 in an XML format XML  formats.

NPI Number : 1326068610 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1326068610",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LAZERE",
    "FirstName": "MONICA",
    "MiddleName": "BRIDGET",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LCSW LMFT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HART",
    "OtherFirstName": "MONICA",
    "OtherMiddleName": "BRIDGET",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2350 SOUTH AVENUE",
    "SecondLineMailingAddress": "STE 102",
    "MailingAddressCityName": "LACROSSE",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "54601",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "608-787-6645",
    "MailingAddressFaxNumber": "608-787-6658",
    "FirstLinePracticeLocationAddress": "2350 SOUTH AVENUE",
    "SecondLinePracticeLocationAddress": "STE 102",
    "PracticeLocationAddressCityName": "LACROSSE",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "54601",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "608-787-6645",
    "PracticeLocationAddressFaxNumber": "608-787-6658",
    "EnumerationDate": "07/20/2006",
    "LastUpdateDate": "07/08/2007",
    "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": "103T00000X",
          "TaxonomyName": "Psychologist",
          "LicenseNumber": "1316",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "103T00000X",
          "TaxonomyName": "Psychologist",
          "LicenseNumber": "242",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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