{
"Npi": {
"NPI": "1952603540",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CHANDLER",
"FirstName": "BRUCE",
"MiddleName": "HOMER",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LCSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CHANDLER",
"OtherFirstName": "BRUCE",
"OtherMiddleName": "HOMER",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "LCSW",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "3447 SAN CARLOS DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WEST VALLEY CITY",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84119-5646",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "801-964-1857",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3447 SAN CARLOS DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WEST VALLEY CITY",
"PracticeLocationAddressStateName": "UT",
"PracticeLocationAddressPostalCode": "84119-5646",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "801-964-1857",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/02/2010",
"LastUpdateDate": "12/02/2010",
"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": "101295-3501",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}