{
"Npi": {
"NPI": "1326630807",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LIMA",
"FirstName": "LESLIE",
"MiddleName": "LOMELI",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "LSCSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1111",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DODGE CITY",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "67801-1111",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "620-682-0605",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "614 N 2ND AVE FL 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DODGE CITY",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "67801-4440",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "620-392-3335",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/06/2021",
"LastUpdateDate": "11/24/2024",
"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": "104100000X",
"TaxonomyName": "Social Worker",
"LicenseNumber": "11899",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "06606",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}