JUDDEE ANNE MAXWELL, MA, LLP, NCP, LMSW - NPI NUMBER 1164666145

Summary

Provider Name: JUDDEE ANNE MAXWELL, MA, LLP, NCP, LMSW

NPI Number: 1164666145

Clasification: Social Worker (104100000X)

Address:
527 COBB ST
CADILLAC, MI
ZIP 49601

Phone Number: (231) 755-3463



Detailed Information

Juddee Anne Maxwell, MA, LLP, NCP, LMSW is a social worker in Cadillac, MI. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. The assigned NPI number for this provider is 1164666145 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

527 COBB ST
CADILLAC, MI
ZIP 49601-540
Phone: (231) 755-3463

The enumeration date for this NPI number is 4/22/2009 and was last updated on 4/22/2009.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 104100000X Social Worker 6801065016 MI No
2 103TB0200X Psychologist Cognitive & Behavioral 6301005541 MI Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1164666145 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name MAXWELL The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name JUDDEE The first name of the provider, if the provider is an individual.
5 Provider Middle Name ANNE The middle name of the provider, if the provider is an individual.
6 Provider Credential Text MA, LLP, NCP, LMSW The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
7 Provider First Line Business Practice Location Address 527 COBB ST The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name CADILLAC The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name MI The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 496012540 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 2317553463 The telephone number associated with the location address of the provider being identified.
13 Provider Enumeration Date 4/22/2009 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 4/22/2009 The date that a record was last updated or changed.
15 Provider Gender Code F The code designating the provider’s gender if the provider is a person.
16 Healthcare Provider Taxonomy Code 1 104100000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
17 Provider License Number 1 6801065016 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
18 Provider License Number State Code 1 MI The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
19 Healthcare Provider Primary Taxonomy Switch 1 N
20 Healthcare Provider Taxonomy Code 2 103TB0200X
21 Provider License Number 2 6301005541 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
22 Provider License Number State Code 2 MI The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
23 Healthcare Provider Primary Taxonomy Switch 2 Y
24 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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