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1790924470 NPI number — CHRISTAL EASON LMSW, CAAC

NPI Number: 1790924470
Health Care Provider/Practitioner: CHRISTAL EASON LMSW, CAAC

Information about “1790924470” NPI (CHRISTAL EASON LMSW, CAAC) exists in 1790924470 in HTML format HTML  |  1790924470 in plain Text format TXT  |  1790924470 in PDF (Portable Document Format) PDF  |  1790924470 in an XML format XML  formats.

NPI Number : 1790924470 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790924470",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "EASON",
    "FirstName": "CHRISTAL",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LMSW, CAAC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "30560 SOUTHFIELD RD APT 239",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SOUTHFIELD",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48076-1228",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "30560 SOUTHFIELD RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SOUTHFIELD",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48076-1228",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "313-784-4795",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/19/2009",
    "LastUpdateDate": "10/22/2025",
    "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": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "C-02091",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "6801080517",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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