NPI Code Detail JSON Logo

1811706369 NPI number — NAKEYA FIELDS LICENSED CLINICAL SOCIAL WORKER PC

NPI Number: 1811706369
Health Care Provider/Practitioner: NAKEYA FIELDS LICENSED CLINICAL SOCIAL WORKER PC

Information about “1811706369” NPI (NAKEYA FIELDS LICENSED CLINICAL SOCIAL WORKER PC) exists in 1811706369 in HTML format HTML  |  1811706369 in plain Text format TXT  |  1811706369 in PDF (Portable Document Format) PDF  |  1811706369 in an XML format XML  formats.

NPI Number : 1811706369 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1811706369",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "NAKEYA FIELDS LICENSED CLINICAL SOCIAL WORKER PC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "530 S LAKE AVE STE 236",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PASADENA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91101-3515",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "213-394-5889",
    "MailingAddressFaxNumber": "213-723-2087",
    "FirstLinePracticeLocationAddress": "5850 6TH AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOS ANGELES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90043-3263",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "213-394-5889",
    "PracticeLocationAddressFaxNumber": "213-723-2087",
    "EnumerationDate": "12/30/2024",
    "LastUpdateDate": "01/04/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "FIELDS",
    "AuthorizedOfficialFirstName": "NAKEYA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CHIEF WELLNESS OFFICER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LCSW",
    "AuthorizedOfficialTelephoneNumber": "323-872-7634",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "252Y00000X",
          "TaxonomyName": "Early Intervention Provider Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QS1000X",
          "TaxonomyName": "Student Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LC1500X",
          "TaxonomyName": "Community Health Nurse Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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