{
"Npi": {
"NPI": "1396023750",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ELLIOTT",
"FirstName": "WENDY",
"MiddleName": "MCCOY",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PH.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MCCOY",
"OtherFirstName": "WENDY",
"OtherMiddleName": "K",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PH.D.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "3708 5TH AVE",
"SecondLineMailingAddress": "MEDICAL ARTS BUILDING, SUITE 401",
"MailingAddressCityName": "PITTSBURGH",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "15213-3427",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "412-802-6696",
"MailingAddressFaxNumber": "412-683-7160",
"FirstLinePracticeLocationAddress": "3708 5TH AVE",
"SecondLinePracticeLocationAddress": "MEDICAL ARTS BUILDING, SUITE 401",
"PracticeLocationAddressCityName": "PITTSBURGH",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "15213-3427",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "412-802-6696",
"PracticeLocationAddressFaxNumber": "412-683-7160",
"EnumerationDate": "08/02/2011",
"LastUpdateDate": "08/02/2011",
"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": "103T00000X",
"TaxonomyName": "Psychologist",
"LicenseNumber": "PS017039",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "103T00000X",
"TaxonomyName": "Psychologist",
"LicenseNumber": "3314",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}