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1578087672 NPI number — MICHELLE VIOLET MCCANN LMSW

NPI Number: 1578087672
Health Care Provider/Practitioner: MICHELLE VIOLET MCCANN LMSW

Information about “1578087672” NPI (MICHELLE VIOLET MCCANN LMSW) exists in 1578087672 in HTML format HTML  |  1578087672 in plain Text format TXT  |  1578087672 in PDF (Portable Document Format) PDF  |  1578087672 in an XML format XML  formats.

NPI Number : 1578087672 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578087672",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCCANN",
    "FirstName": "MICHELLE",
    "MiddleName": "VIOLET",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LMSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "30-92 29TH STREET",
    "SecondLineMailingAddress": "5H",
    "MailingAddressCityName": "ASTORIA",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11102",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "347-479-4284",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3092 29TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ASTORIA",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11102-2774",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "347-479-4284",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/31/2017",
    "LastUpdateDate": "07/21/2022",
    "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": "104100000X",
        "TaxonomyName": "Social Worker",
        "LicenseNumber": "100743-1",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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