Tichiya Maxey, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149018282 Issued in IL

Practice address

805 S 17TH Ave
Maywood, IL 60153-1701

Phone

(708) 450-2015

NPI assigned

Apr 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• M & M Counseling

  • Clinical Social Worker
  • Westchester, IL
  • NPI 1538636139
  NPD (past) Authorized official

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1013371483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 S 17TH AVE",
            "city": "BROADVIEW",
            "state": "IL",
            "postal_code": "601553905",
            "telephone_number": "708-288-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 S 17TH AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601531701",
            "telephone_number": "708-450-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXEY",
        "first_name": "TICHIYA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018282",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "IL",
            "license": "149018282",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Razan Massarani-Wafai, MD
• Benjamin Nathan Massat
• Derek John Matoka, MD
• Georgia Mattingly, DO
• Talia Mavrogiannis
• Brian Mikulan Maxfield, DO
• Tracey Hydrick May
• Natasha Romila Mayer
• Ryan Franklin Mayhew, MD
• Maywood Community Pharmacy LLC

• Clinical Social Worker in Maywood, IL
• Providers in Maywood, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.