{
"Npi": {
"NPI": "1346952538",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HUMPHREY",
"FirstName": "ASHLEY",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LCSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SHORTT",
"OtherFirstName": "ASHLEY",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "4920 LANYARD LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WOODBRIDGE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22192-5746",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "443-804-1007",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "10520 JUDICIAL DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FAIRFAX",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22030-5115",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "703-246-5474",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/19/2022",
"LastUpdateDate": "02/24/2023",
"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": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "0904014665",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}