{"npi":"1972074516","type":"NPI-2","status":"active","name":{"display":"Itic Support Services Group LLC","other":[],"organization_name":"ITIC SUPPORT SERVICES GROUP LLC","authorised_official":"Ryan Morris"},"specialty":{"primary_taxonomy":"1041C0700X","primary_taxonomy_description":"Clinical Social Worker","slug":"clinical-social-worker","schema_org_specialty":null,"all":[{"code":"2084P0800X","description":"Psychiatry","primary":false,"state":null,"license":null},{"code":"363LF0000X","description":"Family Nurse Practitioner","primary":false,"state":null,"license":null},{"code":"363LP0808X","description":"Psychiatric/Mental Health Nurse Practitioner","primary":false,"state":null,"license":null},{"code":"1041C0700X","description":"Clinical Social Worker","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"141 MARKET PL","city":"FAIRVIEW HEIGHTS","state":"IL","postal_code":"622082034","country_code":"US","phone":"3142385260"},{"purpose":"MAILING","street_1":"141 MARKET PL","city":"FAIRVIEW HEIGHTS","state":"IL","postal_code":"622082034","country_code":"US","phone":"3142385260"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"1164929055","state":"IL","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2018-12-07","last_updated":"2019-08-27","_meta":{"source":"NPPES","snapshot_date":"2019-08-27","doc_url":"https://findmynpi.com/api"}}