1962592402 NPI number — KIMBERLY JAYE DAFFRON-BAKER LCSW,LPC-S,LMFT,LCDC

NPI Number: 1962592402
Health Care Provider/Practitioner: KIMBERLY JAYE DAFFRON-BAKER LCSW,LPC-S,LMFT,LCDC

NPI Number : 1962592402 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962592402",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DAFFRON-BAKER",
    "FirstName": "KIMBERLY",
    "MiddleName": "JAYE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "LCSW,LPC-S,LMFT,LCDC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "25806 SANTOLINA",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN ANTONIO",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78261-2672",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "210-896-6215",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "29710 US HIGHWAY 281 N",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BULVERDE",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78163-3107",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "210-896-6215",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/13/2006",
    "LastUpdateDate": "04/10/2020",
    "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": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "12532",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "72729",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": "202430",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "104100000X",
          "TaxonomyName": "Social Worker",
          "LicenseNumber": "62456",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}