Individual provider Active NPI

Juliane Maxwald-Shrey, MA, LP, CASAC

  • Psychoanalyst
  • Long Island City, NY
National Provider Identifier
1003069352
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
000920 Issued in NY
Practice address
531 50TH Ave
Long Island City, NY 11101-5711
Phone
(929) 919-1519
NPI assigned
Oct 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X 000920 NY Primary

Addresses

Primary practice location

531 50TH Ave
Long Island City, NY 11101-5711

Mailing address

150 50TH Ave Apt 2804
Long Island City, NY 11101-6093
Phone (929) 919-1519

Other names 1

  • Juliane Maxwald Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
000920NYMDPsychoanalyst

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1003069352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 50TH AVE APT 2804",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111016093",
            "telephone_number": "929-919-1519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 50TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015711",
            "telephone_number": "929-919-1519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWALD-SHREY",
        "first_name": "JULIANE",
        "credential": "MA, LP, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "000920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIANE",
            "last_name": "MAXWALD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.