{
"Npi": {
"NPI": "1497211387",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WILLIAMS",
"FirstName": "LATASHA",
"MiddleName": "MONIQUE",
"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": "PATRIOT PLACE (VA)",
"SecondLineMailingAddress": "314 WILLIAMS AVENUE, STE. 100",
"MailingAddressCityName": "MADISON",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37115",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "615-521-2560",
"MailingAddressFaxNumber": "615-942-8570",
"FirstLinePracticeLocationAddress": "PATRIOT PLACE (VA)",
"SecondLinePracticeLocationAddress": "314 WILLIAMS AVENUE, STE. 100",
"PracticeLocationAddressCityName": "MADISON",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37115",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "615-521-2560",
"PracticeLocationAddressFaxNumber": "615-942-8570",
"EnumerationDate": "02/15/2019",
"LastUpdateDate": "02/15/2019",
"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": "LCSW-4226",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}