{
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"EIN": null,
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"Credential": "LCM",
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"OtherLastName": "CASSIDY",
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"FirstLineMailingAddress": "10400 RIDGLAND ROAD",
"SecondLineMailingAddress": "STE 1",
"MailingAddressCityName": "COCKEYSVILLE",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21030",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "410-628-6120",
"MailingAddressFaxNumber": "410-628-9825",
"FirstLinePracticeLocationAddress": "100 OWINGS COURT",
"SecondLinePracticeLocationAddress": "SUITE 8",
"PracticeLocationAddressCityName": "REISTERSTOWN",
"PracticeLocationAddressStateName": "MD",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "410-526-7100",
"PracticeLocationAddressFaxNumber": "410-526-7138",
"EnumerationDate": "01/05/2012",
"LastUpdateDate": "08/25/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "000635",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}