{
"Npi": {
"NPI": "1811819642",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SMITH",
"FirstName": "MICHELLE",
"MiddleName": "JOHNSTON",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LMSW, PMH-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SMITH",
"OtherFirstName": "SHELLY",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "LMSW, PMH-C",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "2040 N LOOP 336 W",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CONROE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77304-3500",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "832-515-3841",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2040 N LOOP 336 W",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CONROE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77304-3500",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "832-515-3841",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/25/2026",
"LastUpdateDate": "07/25/2026",
"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": "104100000X",
"TaxonomyName": "Social Worker",
"LicenseNumber": "109014",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}