{
"Npi": {
"NPI": "1346837978",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BROWN",
"FirstName": "STEPHANIE",
"MiddleName": "SARRION",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LCSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SARRION",
"OtherFirstName": "STEPHANIE",
"OtherMiddleName": null,
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "39 BLUE RIDGE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SOUTH WINDSOR",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06074-2808",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "860-778-9161",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "843 MAIN ST STE 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MANCHESTER",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06040-6041",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "860-778-9161",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/29/2020",
"LastUpdateDate": "03/19/2021",
"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": "4634",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "11316",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}