NPI Code Detail JSON Logo

1578178315 NPI number — KRISTA SHABTAIE LCSW

NPI Number: 1578178315
Health Care Provider/Practitioner: KRISTA SHABTAIE LCSW

Information about “1578178315” NPI (KRISTA SHABTAIE LCSW) exists in 1578178315 in HTML format HTML  |  1578178315 in plain Text format TXT  |  1578178315 in PDF (Portable Document Format) PDF  |  1578178315 in an XML format XML  formats.

NPI Number : 1578178315 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578178315",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "KRISTA SHABTAIE LCSW",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "933 N MAYFAIR RD STE 101",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MILWAUKEE",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "53226-3432",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "413-478-8760",
    "MailingAddressFaxNumber": "414-249-5443",
    "FirstLinePracticeLocationAddress": "933 N MAYFAIR RD STE 101",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MILWAUKEE",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "53226-3432",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "413-478-8760",
    "PracticeLocationAddressFaxNumber": "414-249-5443",
    "EnumerationDate": "09/09/2020",
    "LastUpdateDate": "09/09/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SHABTAIE",
    "AuthorizedOfficialFirstName": "KRISTA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "SOCIAL WORKER -- OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LCSW",
    "AuthorizedOfficialTelephoneNumber": "413-478-8760",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0850X",
          "TaxonomyName": "Adult Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0855X",
          "TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0801X",
          "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.