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1366965758 NPI number — ANNA PILLE MORENO LMSW, SSW

NPI Number: 1366965758
Health Care Provider/Practitioner: ANNA PILLE MORENO LMSW, SSW

Information about “1366965758” NPI (ANNA PILLE MORENO LMSW, SSW) exists in 1366965758 in HTML format HTML  |  1366965758 in plain Text format TXT  |  1366965758 in PDF (Portable Document Format) PDF  |  1366965758 in an XML format XML  formats.

NPI Number : 1366965758 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1366965758",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MORENO",
    "FirstName": "ANNA",
    "MiddleName": "PILLE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "LMSW, SSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "7838 MEADOW DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WATERFORD",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48329-4611",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "248-895-9553",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2628 S MILFORD RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HIGHLAND",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48357-4938",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "248-529-3049",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/18/2017",
    "LastUpdateDate": "03/17/2018",
    "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": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "6801062004",
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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