{
"Npi": {
"NPI": "1699008540",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WERONSKI",
"FirstName": "LAURA",
"MiddleName": "QUAGLINO",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LMFT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "QUAGLINO",
"OtherFirstName": "LAURA",
"OtherMiddleName": "NICOLE",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": "LMFT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 15035",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN LUIS OBISPO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93406-5035",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "805-419-5933",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2180 JOHNSON AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN LUIS OBISPO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93401-4513",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "805-419-5933",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/10/2009",
"LastUpdateDate": "04/06/2016",
"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": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "53324",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}