{
"Npi": {
"NPI": "1558468355",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VRTIS-YOUNGER",
"FirstName": "SUSAN",
"MiddleName": "MARIE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LCSW, ACSW, CART",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5010 SANTIAGO CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SIERRA VISTA",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85635-5783",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-556-8214",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "RAYMOND W BLISS ARMY HEALTH CENTER",
"SecondLinePracticeLocationAddress": "2240 E. WINROW AVENUE",
"PracticeLocationAddressCityName": "FORT HUACHUCA",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85613",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-556-8214",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/20/2006",
"LastUpdateDate": "07/25/2025",
"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": "53577",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "34005015A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "C005903",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "L13881",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "LCSW-17844",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}