{"npi":"1336718907","type":"NPI-1","status":"active","name":{"display":"Carrie Wicklund Lmsw","other":[{"code":"1","type":"Formerly known as","value":"MATHIS, CARRIE ELIZABETH"}],"first":"CARRIE","last":"WICKLUND","middle":"ELIZABETH","credential":"LMSW"},"specialty":{"primary_taxonomy":"1041C0700X","primary_taxonomy_description":"Clinical Social Worker","slug":"clinical-social-worker","schema_org_specialty":null,"all":[{"code":"1041C0700X","description":"Clinical Social Worker","primary":true,"state":"MI","license":"6801116981"}]},"addresses":[{"purpose":"LOCATION","street_1":"275 MICHIGAN ST NE","city":"GRAND RAPIDS","state":"MI","postal_code":"495032531","country_code":"US","phone":"6162677900","fax":"6162677901"},{"purpose":"MAILING","street_1":"100 MICHIGAN ST NE # MC845","city":"GRAND RAPIDS","state":"MI","postal_code":"495032560","country_code":"US"}],"license":{"state":"MI","number":"6801116981"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20231009000909","type_code":"14-80","type_desc":"PRACTITIONER - CLINICAL SOCIAL WORKER","state":"MI","pac_id":"1658726872"}]},"enumeration_date":"2021-06-18","last_updated":"2024-12-09","_meta":{"source":"NPPES","snapshot_date":"2024-12-09","doc_url":"https://findmynpi.com/api"}}