1700905395 NPI number — JOANN LUSKY L.I.C.S.W.

NPI Number: 1700905395
Health Care Provider/Practitioner: JOANN LUSKY L.I.C.S.W.

NPI Number : 1700905395 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700905395",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LUSKY",
    "FirstName": "JOANN",
    "MiddleName": null,
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "L.I.C.S.W.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KASINGER",
    "OtherFirstName": "JOANN",
    "OtherMiddleName": "LUSKY",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "L.C.S.W.",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "13215 SE MILL PLAIN BLVD",
    "SecondLineMailingAddress": "SUITE C8",
    "MailingAddressCityName": "VANCOUVER",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98684-6991",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "360-735-1114",
    "MailingAddressFaxNumber": "360-735-0090",
    "FirstLinePracticeLocationAddress": "2502 SE 134TH CT",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "VANCOUVER",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98683-6693",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "360-735-1114",
    "PracticeLocationAddressFaxNumber": "360-735-0090",
    "EnumerationDate": "03/28/2007",
    "LastUpdateDate": "09/03/2014",
    "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": "1084",
          "LicenseNumberStateCode": "OR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "1261",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}