{
"Npi": {
"NPI": "1336675768",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VORDERSTRASSE",
"FirstName": "VALERIE",
"MiddleName": "MARIE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PSY.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "242 LAUREL RIDGE LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTH KINGSTOWN",
"MailingAddressStateName": "RI",
"MailingAddressPostalCode": "02852-4151",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "860-255-8115",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1130 TEN ROD RD STE C205D",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTH KINGSTOWN",
"PracticeLocationAddressStateName": "RI",
"PracticeLocationAddressPostalCode": "02852-4167",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "401-329-6336",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/04/2017",
"LastUpdateDate": "12/08/2022",
"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": "103TM1800X",
"TaxonomyName": "Intellectual & Developmental Disabilities Psychologist",
"LicenseNumber": "10808-PY-PR",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TM1800X",
"TaxonomyName": "Intellectual & Developmental Disabilities Psychologist",
"LicenseNumber": "2014014302",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TC2200X",
"TaxonomyName": "Clinical Child & Adolescent Psychologist",
"LicenseNumber": "10808-PY-PR",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TC2200X",
"TaxonomyName": "Clinical Child & Adolescent Psychologist",
"LicenseNumber": "PS01631",
"LicenseNumberStateCode": "RI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TM1800X",
"TaxonomyName": "Intellectual & Developmental Disabilities Psychologist",
"LicenseNumber": "PS01631",
"LicenseNumberStateCode": "RI",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}