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1487346920 NPI number — SAMANTHA RONNEL QUERUBIN-CHAVEZ LMSW U/S

NPI Number: 1487346920
Health Care Provider/Practitioner: SAMANTHA RONNEL QUERUBIN-CHAVEZ LMSW U/S

Information about “1487346920” NPI (SAMANTHA RONNEL QUERUBIN-CHAVEZ LMSW U/S) exists in 1487346920 in HTML format HTML  |  1487346920 in plain Text format TXT  |  1487346920 in PDF (Portable Document Format) PDF  |  1487346920 in an XML format XML  formats.

NPI Number : 1487346920 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1487346920",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "QUERUBIN-CHAVEZ",
    "FirstName": "SAMANTHA",
    "MiddleName": "RONNEL",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LMSW U/S",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "13224 SE 202ND RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TALIHINA",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "74571-5866",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "918-567-2389",
    "MailingAddressFaxNumber": "918-567-2417",
    "FirstLinePracticeLocationAddress": "13224 SE 202ND RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TALIHINA",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "74571-5866",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "918-567-2389",
    "PracticeLocationAddressFaxNumber": "918-567-2417",
    "EnumerationDate": "05/23/2023",
    "LastUpdateDate": "05/23/2023",
    "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": "104100000X",
        "TaxonomyName": "Social Worker",
        "LicenseNumber": "20158-P",
        "LicenseNumberStateCode": "OK",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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