{
"Npi": {
"NPI": "1972672087",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DRAAYER-THIBODEAU",
"FirstName": "DAWN",
"MiddleName": "DIANA",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LICSW",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "12848 INDEPENDENCE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAVAGE",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55378-1189",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "952-334-1213",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4500 PARK GLEN RD STE 155",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ST LOUIS PARK",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55416-4888",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "952-334-1213",
"PracticeLocationAddressFaxNumber": "952-928-9774",
"EnumerationDate": "11/06/2006",
"LastUpdateDate": "07/08/2007",
"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": "15185",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}