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1578293080 NPI number — MADDISON PASSION STAHMER LCSW

NPI Number: 1578293080
Health Care Provider/Practitioner: MADDISON PASSION STAHMER LCSW

Information about “1578293080” NPI (MADDISON PASSION STAHMER LCSW) exists in 1578293080 in HTML format HTML  |  1578293080 in plain Text format TXT  |  1578293080 in PDF (Portable Document Format) PDF  |  1578293080 in an XML format XML  formats.

NPI Number : 1578293080 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578293080",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STAHMER",
    "FirstName": "MADDISON",
    "MiddleName": "PASSION",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "RUSSO",
    "OtherFirstName": "MADDISON",
    "OtherMiddleName": "PASSION",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "LCSW",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "267 OAK ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BRIDGEWATER",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "02324-1526",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "508-273-6284",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "267 OAK ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BRIDGEWATER",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "02324-1526",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "508-273-6284",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/16/2022",
    "LastUpdateDate": "06/16/2022",
    "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": "228054",
        "LicenseNumberStateCode": "MA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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