NPI Code Detail JSON Logo

1962768572 NPI number — JULIET IHEDIKE LCSW

NPI Number: 1962768572
Health Care Provider/Practitioner: JULIET IHEDIKE LCSW

Information about “1962768572” NPI (JULIET IHEDIKE LCSW) exists in 1962768572 in HTML format HTML  |  1962768572 in plain Text format TXT  |  1962768572 in PDF (Portable Document Format) PDF  |  1962768572 in an XML format XML  formats.

NPI Number : 1962768572 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962768572",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "IHEDIKE",
    "FirstName": "JULIET",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "IFEOBU",
    "OtherFirstName": "JULIET",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MSW",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "110 EVANS MILL DR STE 305",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DALLAS",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30157-1623",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "678-348-6390",
    "MailingAddressFaxNumber": "678-550-6380",
    "FirstLinePracticeLocationAddress": "110 EVANS MILL DR STE 305",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DALLAS",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30157-1623",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "678-348-6390",
    "PracticeLocationAddressFaxNumber": "678-550-6380",
    "EnumerationDate": "04/09/2012",
    "LastUpdateDate": "08/28/2022",
    "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": "CSW007463",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "172V00000X",
          "TaxonomyName": "Community Health Worker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.