{
"Npi": {
"NPI": "1811326390",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ASHBY-WILSON",
"FirstName": "SADIELYN",
"MiddleName": null,
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LCSW-R",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5100 W TAFT RD STE 1F",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LIVERPOOL",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "13088-3808",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "315-458-6111",
"MailingAddressFaxNumber": "315-458-6121",
"FirstLinePracticeLocationAddress": "5100 W TAFT RD STE 1F",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LIVERPOOL",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "13088-3808",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "315-458-6111",
"PracticeLocationAddressFaxNumber": "315-458-6121",
"EnumerationDate": "11/05/2013",
"LastUpdateDate": "09/29/2020",
"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": "CW018307",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "1414",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "078066",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}