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1881142628 NPI number — VINCENT MICHAEL VISIOLI LCSW

NPI Number: 1881142628
Health Care Provider/Practitioner: VINCENT MICHAEL VISIOLI LCSW

Information about “1881142628” NPI (VINCENT MICHAEL VISIOLI LCSW) exists in 1881142628 in HTML format HTML  |  1881142628 in plain Text format TXT  |  1881142628 in PDF (Portable Document Format) PDF  |  1881142628 in an XML format XML  formats.

NPI Number : 1881142628 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1881142628",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "VISIOLI",
    "FirstName": "VINCENT",
    "MiddleName": "MICHAEL",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1091 ROSEBERRY CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MORGANVILLE",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07751-1783",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "732-434-8970",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4400 ROUTE 9 S",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FREEHOLD",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07728-1383",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "732-434-8970",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/21/2016",
    "LastUpdateDate": "09/21/2016",
    "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": "44SC05501100",
        "LicenseNumberStateCode": "NJ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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