{
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"FirstLineMailingAddress": "209 MERRIWEATHER RD",
"SecondLineMailingAddress": null,
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"MailingAddressStateName": "MI",
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"FirstLinePracticeLocationAddress": "209 MERRIWEATHER RD",
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"EnumerationDate": "05/06/2008",
"LastUpdateDate": "10/05/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VORHEES",
"AuthorizedOfficialFirstName": "RANDALL",
"AuthorizedOfficialMiddleName": "FIELDER",
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"AuthorizedOfficialCredential": "MSW",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Clinical Social Worker",
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"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}