{"npi":"1780600858","type":"NPI-1","status":"active","name":{"display":"Dr. Shauna Ezell PHD, LCSW","other":[{"code":"1","type":"Formerly known as","value":"JOHNSON, SHAUNA M."}],"first":"SHAUNA","last":"EZELL","middle":"M.","credential":"PHD, LCSW"},"specialty":{"primary_taxonomy":"103TC0700X","primary_taxonomy_description":"Clinical Psychologist","slug":"clinical-psychologist","schema_org_specialty":null,"all":[{"code":"1041C0700X","description":"Clinical Social Worker","primary":false,"state":"WI","license":"7400-123"},{"code":"103TC0700X","description":"Clinical Psychologist","primary":true,"state":"WI","license":"3097-57"}]},"addresses":[{"purpose":"LOCATION","street_1":"325TH MEDICAL GROUP","city":"TYNDALL AFB","state":"FL","postal_code":"324035604","country_code":"US","street_2":"340 MAGNOLIA CIRCLE, BLDG. 1465","phone":"8502837511"},{"purpose":"MAILING","street_1":"340 MAGNOLIA CIR BLDG 1465","city":"TYNDALL AFB","state":"FL","postal_code":"324035604","country_code":"US","phone":"8502837511"}],"license":{"state":"WI","number":"3097-57"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"524139100","state":"MN","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-07-14","last_updated":"2026-01-23","_meta":{"source":"NPPES","snapshot_date":"2026-01-23","doc_url":"https://findmynpi.com/api"}}