{
"Npi": {
"NPI": "1629018262",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "X",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WALSH",
"FirstName": "MARIBETH",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LCSWC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WESTFALL",
"OtherFirstName": "MARY",
"OtherMiddleName": "E",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 1945",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HAGERSTOWN",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21742-1945",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-733-0330",
"MailingAddressFaxNumber": "301-733-4038",
"FirstLinePracticeLocationAddress": "13218 BROOKLANE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HAGERSTOWN",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21742-1435",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-733-0330",
"PracticeLocationAddressFaxNumber": "301-733-4038",
"EnumerationDate": "06/08/2006",
"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": "08996",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}