{
"Npi": {
"NPI": "1932424843",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "STYLIANOU",
"FirstName": "AMANDA",
"MiddleName": "MATHISEN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LCSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MATHISEN",
"OtherFirstName": "AMANDA",
"OtherMiddleName": "MARIE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "84 ROUTE 31 NORTH",
"SecondLineMailingAddress": "SUITE 200",
"MailingAddressCityName": "PENNINGTON",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08534",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "609-647-7875",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "84 ROUTE 31 NORTH",
"SecondLinePracticeLocationAddress": "SUITE 200",
"PracticeLocationAddressCityName": "PENNINGTON",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "08534",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "609-647-7875",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/02/2010",
"LastUpdateDate": "01/07/2011",
"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": "44SL05502400",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "44SC054440000",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}