{
"Npi": {
"NPI": "1962994343",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RODRIGUEZ",
"FirstName": "AMBER",
"MiddleName": "LYN",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LCSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MANFREDI",
"OtherFirstName": "AMBER",
"OtherMiddleName": "LYN",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": "ASW",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "11332 PENSIVE PT APT 209",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLORADO SPRINGS",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80921-4306",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-279-7997",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "11332 PENSIVE PT",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COLORADO SPRINGS",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80921-4304",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-279-7997",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/01/2018",
"LastUpdateDate": "03/21/2022",
"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": "104792",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}