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1962553453 NPI number — CEDAR TREE

NPI Number: 1962553453
Health Care Provider/Practitioner: CEDAR TREE

Information about “1962553453” NPI (CEDAR TREE) exists in 1962553453 in HTML format HTML  |  1962553453 in plain Text format TXT  |  1962553453 in PDF (Portable Document Format) PDF  |  1962553453 in an XML format XML  formats.

NPI Number : 1962553453 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962553453",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CEDAR TREE",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "403 E MICHIGAN ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MARQUETTE",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "49855-3827",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "906-228-5494",
    "MailingAddressFaxNumber": "906-228-5494",
    "FirstLinePracticeLocationAddress": "403 E MICHIGAN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MARQUETTE",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "49855-3827",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "906-228-5494",
    "PracticeLocationAddressFaxNumber": "906-228-5494",
    "EnumerationDate": "01/13/2007",
    "LastUpdateDate": "08/22/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MAGNUSON",
    "AuthorizedOfficialFirstName": "JON",
    "AuthorizedOfficialMiddleName": "WILLIAM",
    "AuthorizedOfficialTitle": "DIRECTOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MSW ACSW",
    "AuthorizedOfficialTelephoneNumber": "906-228-5494",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "6801070289",
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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