1861115974 NPI number — LAKSHMI LUCIA FRIGO PH.D., M.S.W.

NPI Number: 1861115974
Health Care Provider/Practitioner: LAKSHMI LUCIA FRIGO PH.D., M.S.W.

NPI Number : 1861115974 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861115974",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FRIGO",
    "FirstName": "LAKSHMI",
    "MiddleName": "LUCIA",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PH.D., M.S.W.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "FRIGO",
    "OtherFirstName": "DANIEL",
    "OtherMiddleName": "CALLISTUS",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PH.D., M.S.W.",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "6631 ALAMO AVE APT 1W",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAINT LOUIS",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "63105-3130",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "651-319-2742",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6631 ALAMO AVE APT 1W",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAINT LOUIS",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "63105-3130",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "651-319-2742",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/22/2022",
    "LastUpdateDate": "04/07/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "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": "2024022110",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "SWB-2022-1089",
          "LicenseNumberStateCode": "NM",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "15966",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}