{
"Npi": {
"NPI": "1912639287",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JOHNSON",
"FirstName": "JAKEIA",
"MiddleName": null,
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LICSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WILLIAMS",
"OtherFirstName": "JAKEIA",
"OtherMiddleName": null,
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "4449 SOUTH DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PINSON",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35126-2843",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "205-527-3503",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "85 BAGBY DR STE 336",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOMEWOOD",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "35209-3717",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "205-545-0874",
"PracticeLocationAddressFaxNumber": "205-377-7762",
"EnumerationDate": "06/27/2022",
"LastUpdateDate": "08/15/2022",
"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": "4626C",
"LicenseNumberStateCode": "AL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}