{
"Npi": {
"NPI": "1518134014",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BARANCZYK",
"FirstName": "PAMELA",
"MiddleName": "L",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LCSW,SAC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LARDINOIS",
"OtherFirstName": "PAMELA",
"OtherMiddleName": "L",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "LCSW,SAC",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 22040",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREEN BAY",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "54305-2040",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "920-445-7222",
"MailingAddressFaxNumber": "920-445-7289",
"FirstLinePracticeLocationAddress": "301 E SAINT JOSEPH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GREEN BAY",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "54301-2241",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "920-433-6073",
"PracticeLocationAddressFaxNumber": "920-431-0333",
"EnumerationDate": "05/14/2008",
"LastUpdateDate": "02/11/2021",
"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": "8375-123",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": "15270",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}