{
"Npi": {
"NPI": "1720163942",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "OLSON",
"FirstName": "CAROLE",
"MiddleName": "C",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "PSYD.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4 N. PINE STREET",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NINANTIC",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06357",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "401-862-9651",
"MailingAddressFaxNumber": "310-659-9217",
"FirstLinePracticeLocationAddress": "4 N. PINE STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NINANTIC",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06357",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "401-862-9651",
"PracticeLocationAddressFaxNumber": "310-659-9217",
"EnumerationDate": "10/26/2006",
"LastUpdateDate": "06/03/2019",
"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": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "3661",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "PS00750",
"LicenseNumberStateCode": "RI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "PSY22829",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}