{
"Npi": {
"NPI": "1346731270",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SIMMONS",
"FirstName": "JENNIFER",
"MiddleName": "ENITH",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LMSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SIMMONS",
"OtherFirstName": "JENNIFER",
"OtherMiddleName": "ENITH",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "550 GRAND AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LINDENHURST",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11757-3110",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-942-2703",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1841 BRENTWOOD RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BRENTWOOD",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11717-4625",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-853-7300",
"PracticeLocationAddressFaxNumber": "631-853-7301",
"EnumerationDate": "05/26/2018",
"LastUpdateDate": "05/26/2018",
"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": "101424",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}