{
  "npi": "1811125974",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2021-04-22",
    "credential": "LCSW",
    "enumeration_date": "2009-06-29",
    "first_name": "LARA",
    "last_name": "BERGSTEDT",
    "last_updated": "2021-04-22",
    "middle_name": "M",
    "sex": "F",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "323 W MULBERRY ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "WATSEKA",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "609701568",
      "state": "IL",
      "telephone_number": "815-432-5241"
    },
    {
      "address_1": "3446 191ST ST",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "LANSING",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "604383848",
      "state": "IL",
      "telephone_number": "708-837-8377"
    }
  ],
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    {
      "code": "1041C0700X",
      "desc": "Social Worker, Clinical",
      "license": "LSW0000006090",
      "primary": false,
      "state": "TN",
      "taxonomy_group": ""
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    {
      "code": "1041C0700X",
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      "primary": false,
      "state": "IN",
      "taxonomy_group": ""
    },
    {
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      "license": "149.013607",
      "primary": true,
      "state": "IL",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
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      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "80",
        "medicare_type": "Licensed Clinical Social Worker"
      }
    ]
  }
}