{
"Npi": {
"NPI": "1841243854",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WOODS PSYCHOTHERAPY SERVICES, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "100 STRAUBE CENTER BLVD",
"SecondLineMailingAddress": "BOX H-1",
"MailingAddressCityName": "PENNINGTON",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08534-1447",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "609-737-7797",
"MailingAddressFaxNumber": "609-737-7499",
"FirstLinePracticeLocationAddress": "100 STRAUBE CENTER BLVD",
"SecondLinePracticeLocationAddress": "BOX H-1",
"PracticeLocationAddressCityName": "PENNINGTON",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "08534-1447",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "609-737-7797",
"PracticeLocationAddressFaxNumber": "609-737-7499",
"EnumerationDate": "05/19/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOODS",
"AuthorizedOfficialFirstName": "JONATHAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCSW",
"AuthorizedOfficialTelephoneNumber": "609-737-7797",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "44SC00276100",
"LicenseNumberStateCode": "NJ",
"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."
}
}
}
}