{
"Npi": {
"NPI": "1558469254",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BRENDEL",
"FirstName": "KRISTEN",
"MiddleName": "LEE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "LCSW, PHD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "ESPOSITO",
"OtherFirstName": "KRISTEN",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PHD, LCSW",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "3380 LACROSSE LN STE 111",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NAPERVILLE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60564-8521",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-474-5119",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "324 W STATE ST",
"SecondLinePracticeLocationAddress": "SUITE 110",
"PracticeLocationAddressCityName": "GENEVA",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60134-2178",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-474-5119",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/20/2006",
"LastUpdateDate": "02/07/2024",
"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": "IL149009642",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}