{
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"FirstLineMailingAddress": "6 COPPERFIELD LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LONDONDERRY",
"MailingAddressStateName": "NH",
"MailingAddressPostalCode": "03053-3265",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "80 NASHUA RD",
"SecondLinePracticeLocationAddress": "BUILDING C, LOWER LEVEL",
"PracticeLocationAddressCityName": "LONDONDERRY",
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"PracticeLocationAddressTelephoneNumber": "617-803-0644",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/29/2018",
"LastUpdateDate": "10/29/2018",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ILLER",
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"AuthorizedOfficialTitle": "THERAPIST",
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"AuthorizedOfficialCredential": "LICSW",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}