1548212996 NPI number — HENRY HIMMELBAUM L.C.S.W.

NPI Number: 1548212996
Health Care Provider/Practitioner: HENRY HIMMELBAUM L.C.S.W.

NPI Number : 1548212996 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1548212996",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HIMMELBAUM",
    "FirstName": "HENRY",
    "MiddleName": null,
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "L.C.S.W.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HIMMELBAUM",
    "OtherFirstName": "HENRY",
    "OtherMiddleName": "NMN",
    "OtherNamePrefix": "MR.",
    "OtherNameSuffix": null,
    "OtherCredential": "L.C.S.W.",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "666 MONACO COURT, BLDG N",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DELRAY BEACH",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33446-1949",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "561-716-4840",
    "MailingAddressFaxNumber": "954-431-0413",
    "FirstLinePracticeLocationAddress": "666 MONACO COURT, BLDG N",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DELRAY BEACH",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33446-1949",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "561-716-4840",
    "PracticeLocationAddressFaxNumber": "954-431-0413",
    "EnumerationDate": "05/16/2006",
    "LastUpdateDate": "11/20/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "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": "SW 3203",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}