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1467027649 NPI number — JAKOB MAUER LICSW, LCSW

NPI Number: 1467027649
Health Care Provider/Practitioner: JAKOB MAUER LICSW, LCSW

Information about “1467027649” NPI (JAKOB MAUER LICSW, LCSW) exists in 1467027649 in HTML format HTML  |  1467027649 in plain Text format TXT  |  1467027649 in PDF (Portable Document Format) PDF  |  1467027649 in an XML format XML  formats.

NPI Number : 1467027649 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1467027649",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MAUER",
    "FirstName": "JAKOB",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LICSW, LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "10650 DEAN MARTIN DR UNIT 412",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAS VEGAS",
    "MailingAddressStateName": "NV",
    "MailingAddressPostalCode": "89141-3589",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "406-396-5168",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1070 W HORIZON RIDGE PKWY STE 210",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HENDERSON",
    "PracticeLocationAddressStateName": "NV",
    "PracticeLocationAddressPostalCode": "89012-6020",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "702-405-0904",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/20/2021",
    "LastUpdateDate": "01/23/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "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": "9244-S",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "29066",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "10450-C",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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