{
"Npi": {
"NPI": "1861931396",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HSU",
"FirstName": "PAMELA",
"MiddleName": "L",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LISW-S",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LEE",
"OtherFirstName": "PAMELA",
"OtherMiddleName": "L",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "LSW",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1587 E 31ST ST",
"SecondLineMailingAddress": "#205",
"MailingAddressCityName": "CLEVELAND",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44114-4366",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8500 STATION ST STE 102",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MENTOR",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44060-4968",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "216-245-7811",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/16/2017",
"LastUpdateDate": "04/14/2020",
"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": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "I.1800797",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "S.1502317",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}