{
"Npi": {
"NPI": "1366682411",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GUIDA",
"FirstName": "SUSAN",
"MiddleName": "JEAN",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "LCSW-R",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GUIDA",
"OtherFirstName": "SUSAN",
"OtherMiddleName": "JEAN",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": "LCSW-R",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "43 DOGWOOD RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALBERTSON",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11507-1003",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-621-2854",
"MailingAddressFaxNumber": "516-621-2854",
"FirstLinePracticeLocationAddress": "626 WILLIS AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WILLISTON PARK",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11596-1149",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "516-621-2854",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/03/2009",
"LastUpdateDate": "07/23/2010",
"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": "RO69724 1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "R069724 1",
"LicenseNumberStateCode": "NV",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}