{
"Npi": {
"NPI": "1346745478",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FOCKEN",
"FirstName": "SARAH",
"MiddleName": "E",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "VEDDER",
"OtherFirstName": "SARAH",
"OtherMiddleName": "E",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "LISW",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "130 WESTROCK FARM DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "UNION",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45322-8731",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "531-229-3990",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "12 W WENGER RD # 7",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ENGLEWOOD",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45322-2754",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "531-229-3990",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/29/2018",
"LastUpdateDate": "06/03/2025",
"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": "S1801960",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "I.2103123",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}