{
"Npi": {
"NPI": "1659700912",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KATHRYN FALLIN, M.S.",
"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": "11 CEDAR GLN N",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SOUTH BURLINGTON",
"MailingAddressStateName": "VT",
"MailingAddressPostalCode": "05403-7334",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "802-578-9728",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3 MAIN ST",
"SecondLinePracticeLocationAddress": "STE. 216",
"PracticeLocationAddressCityName": "BURLINGTON",
"PracticeLocationAddressStateName": "VT",
"PracticeLocationAddressPostalCode": "05401-5216",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "802-651-7514",
"PracticeLocationAddressFaxNumber": "802-860-1234",
"EnumerationDate": "11/07/2013",
"LastUpdateDate": "11/07/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FALLIN",
"AuthorizedOfficialFirstName": "KATHRYN",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "PSYCHOLOGIST MASTER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.S.",
"AuthorizedOfficialTelephoneNumber": "802-651-7514",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "047.0093667",
"LicenseNumberStateCode": "VT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}