{
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"FirstLineMailingAddress": "114 SOMERSET ST",
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"MailingAddressCityName": "WEST HARTFORD",
"MailingAddressStateName": "CT",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "674 PROSPECT AVE",
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"EnumerationDate": "02/02/2006",
"LastUpdateDate": "08/22/2020",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "BRUBECK",
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"AuthorizedOfficialCredential": "LCSW",
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"Taxonomies": {
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"TaxonomyName": "Clinical Social Worker",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}