{
"Npi": {
"NPI": "1700830346",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DAGUE",
"FirstName": "KAREN",
"MiddleName": "M",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LCSW-R",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "YACANO",
"OtherFirstName": "KAREN",
"OtherMiddleName": "M",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "5 COURT STREET",
"SecondLineMailingAddress": "STE 42",
"MailingAddressCityName": "NORWICH",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "13815",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "607-337-1600",
"MailingAddressFaxNumber": "607-334-4519",
"FirstLinePracticeLocationAddress": "5 COURT STREET",
"SecondLinePracticeLocationAddress": "STE 42",
"PracticeLocationAddressCityName": "NORWICH",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "13815",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "607-337-1600",
"PracticeLocationAddressFaxNumber": "607-334-4519",
"EnumerationDate": "05/19/2006",
"LastUpdateDate": "12/20/2024",
"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": "R049829",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}