{
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"OrgName": "PATRICK COUNTY DEPARTMENT OF SOCIAL SERVICES",
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"NamePrefix": null,
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"FirstLineMailingAddress": "106 RUCKER ST",
"SecondLineMailingAddress": "SUITE 128",
"MailingAddressCityName": "STUART",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "24171-1619",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "276-694-3328",
"MailingAddressFaxNumber": "276-694-8210",
"FirstLinePracticeLocationAddress": "106 RUCKER ST",
"SecondLinePracticeLocationAddress": "SUITE 128",
"PracticeLocationAddressCityName": "STUART",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "276-694-3328",
"PracticeLocationAddressFaxNumber": "276-694-8210",
"EnumerationDate": "08/12/2006",
"LastUpdateDate": "07/21/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TATUM",
"AuthorizedOfficialFirstName": "DEBORAH",
"AuthorizedOfficialMiddleName": "R.",
"AuthorizedOfficialTitle": "SENIOR SOCIAL WORKER",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "S.W.",
"AuthorizedOfficialTelephoneNumber": "276-694-3328",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251K00000X",
"TaxonomyName": "Public Health or Welfare Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}