Individual provider Active NPI

Maxine Whitman, LCSW

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1073523809
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7219-123 Issued in WI
Practice address
6401 Odana Rd Ste a
Madison, WI 53719-1126
Phone
(608) 204-6076
Fax
(608) 204-9568
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7219-123 WI Primary

Addresses

Primary practice location

6401 Odana Rd Ste a
Madison, WI 53719-1126

Mailing address

6401 Odana Rd Ste a
Madison, WI 53719-1126
Phone (608) 204-6076

Other identifiers 1

IdentifierTypeStateIssuer
41003600MedicaidWI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7219-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Solutions LTD Past Accepting new patients
Sonas Behavioral Health LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1073523809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 ODANA RD STE A",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191126",
            "telephone_number": "608-204-6076",
            "fax_number": "608-204-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 ODANA RD STE A",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191126",
            "telephone_number": "608-204-6076",
            "fax_number": "608-204-9568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMAN",
        "first_name": "MAXINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7219-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41003600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.