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1558489989 NPI number — AMY L BRYANT LCSW

NPI Number: 1558489989
Health Care Provider/Practitioner: AMY L BRYANT LCSW

Information about “1558489989” NPI (AMY L BRYANT LCSW) exists in 1558489989 in HTML format HTML  |  1558489989 in plain Text format TXT  |  1558489989 in PDF (Portable Document Format) PDF  |  1558489989 in an XML format XML  formats.

NPI Number : 1558489989 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558489989",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BRYANT",
    "FirstName": "AMY",
    "MiddleName": "L",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SEBBY",
    "OtherFirstName": "AMY",
    "OtherMiddleName": "L",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1425 S HIGLEY RD STE 104",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HIGLEY",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85236-4704",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "480-240-0386",
    "MailingAddressFaxNumber": "480-240-4151",
    "FirstLinePracticeLocationAddress": "1425 S HIGLEY RD STE 104",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HIGLEY",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85236-4704",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "480-240-0386",
    "PracticeLocationAddressFaxNumber": "480-240-4151",
    "EnumerationDate": "03/26/2007",
    "LastUpdateDate": "07/08/2007",
    "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": "LCSW10689",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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