{
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"OrgName": "SACRED HEART HEALING CENTER",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "608 RIVERSIDE DRIVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROME",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "13440",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "315-335-4592",
"MailingAddressFaxNumber": "315-336-4800",
"FirstLinePracticeLocationAddress": "310 E. CHESTNUT ST.",
"SecondLinePracticeLocationAddress": "SUITE 14",
"PracticeLocationAddressCityName": "ROME",
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"PracticeLocationAddressTelephoneNumber": "315-335-4592",
"PracticeLocationAddressFaxNumber": "315-336-4800",
"EnumerationDate": "03/12/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EMETERIO",
"AuthorizedOfficialFirstName": "CHARLENE",
"AuthorizedOfficialMiddleName": "E.",
"AuthorizedOfficialTitle": "OWNER, PRIVATE PRACTICE",
"AuthorizedOfficialNamePrefix": "MS.",
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"AuthorizedOfficialCredential": "LCSW-R, BCD",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "R053289",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}