{
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"FirstLineMailingAddress": "970 ILLINOIS AVE.",
"SecondLineMailingAddress": null,
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "207-990-3660",
"FirstLinePracticeLocationAddress": "970 ILLINOIS AVE.",
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"PracticeLocationAddressTelephoneNumber": "207-945-4240",
"PracticeLocationAddressFaxNumber": "207-990-3660",
"EnumerationDate": "05/02/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NESBIT",
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"AuthorizedOfficialTelephoneNumber": "207-299-1132",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Clinical Social Worker",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}