NPI Code Detail JSON Logo

1457111965 NPI number — MARY AMANDA ALLS LCSW

NPI Number: 1457111965
Health Care Provider/Practitioner: MARY AMANDA ALLS LCSW

Information about “1457111965” NPI (MARY AMANDA ALLS LCSW) exists in 1457111965 in HTML format HTML  |  1457111965 in plain Text format TXT  |  1457111965 in PDF (Portable Document Format) PDF  |  1457111965 in an XML format XML  formats.

NPI Number : 1457111965 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1457111965",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ALLS",
    "FirstName": "MARY",
    "MiddleName": "AMANDA",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1816 N CLEVELAND ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LITTLE ROCK",
    "MailingAddressStateName": "AR",
    "MailingAddressPostalCode": "72207-4221",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "501-392-4303",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1816 N CLEVELAND ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LITTLE ROCK",
    "PracticeLocationAddressStateName": "AR",
    "PracticeLocationAddressPostalCode": "72207-4221",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "501-392-4303",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/21/2024",
    "LastUpdateDate": "03/21/2024",
    "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": "99317",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "3052-C",
          "LicenseNumberStateCode": "AR",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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