1811035868 NPI number — CAROLE A DOORLEY L.C.S.W.

NPI Number: 1811035868
Health Care Provider/Practitioner: CAROLE A DOORLEY L.C.S.W.

NPI Number : 1811035868 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1811035868",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DOORLEY",
    "FirstName": "CAROLE",
    "MiddleName": "A",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "L.C.S.W.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1502 W NC HIGHWAY 54",
    "SecondLineMailingAddress": "STE 103",
    "MailingAddressCityName": "DURHAM",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27707-5572",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "908-232-2052",
    "MailingAddressFaxNumber": "908-232-8809",
    "FirstLinePracticeLocationAddress": "21 E HIGH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SOMERVILLE",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "08876-2320",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "908-927-9955",
    "PracticeLocationAddressFaxNumber": "908-232-8809",
    "EnumerationDate": "02/02/2007",
    "LastUpdateDate": "01/16/2019",
    "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": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "44SC04537400",
        "LicenseNumberStateCode": "NJ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}