NPI Code Detail JSON Logo

1508373788 NPI number — MELANIE LAURA JOHNSON LICSW, PIP

NPI Number: 1508373788
Health Care Provider/Practitioner: MELANIE LAURA JOHNSON LICSW, PIP

Information about “1508373788” NPI (MELANIE LAURA JOHNSON LICSW, PIP) exists in 1508373788 in HTML format HTML  |  1508373788 in plain Text format TXT  |  1508373788 in PDF (Portable Document Format) PDF  |  1508373788 in an XML format XML  formats.

NPI Number : 1508373788 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508373788",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JOHNSON",
    "FirstName": "MELANIE",
    "MiddleName": "LAURA",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LICSW, PIP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "JOHNSON",
    "OtherFirstName": "LAURA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LICSW, PIP",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "PO BOX 660843",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "VESTAVIA",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35266-0843",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "205-837-8220",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4289 GLASCOTT XING",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOOVER",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "35226-6376",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "205-837-8220",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/09/2018",
    "LastUpdateDate": "02/21/2024",
    "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": "3634C",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "1365-3634C",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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