1639539927 NPI number — CECILIA HERRERA LEGGETT L.C.S.W.

NPI Number: 1639539927
Health Care Provider/Practitioner: CECILIA HERRERA LEGGETT L.C.S.W.

NPI Number : 1639539927 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1639539927",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LEGGETT",
    "FirstName": "CECILIA",
    "MiddleName": "HERRERA",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "L.C.S.W.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2146 W PINE AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MERIDIAN",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83642-5434",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "618-528-0342",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3300 NW 50TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OKLAHOMA CITY",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "73112-5628",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "405-810-5200",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/29/2016",
    "LastUpdateDate": "09/03/2024",
    "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": "104581",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "CSW.09926718",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "6158",
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}