Active NPI
Maxine Whitman, LCSW
- Clinical Social Worker
- Madison, WI
National Provider Identifier
1073523809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7219-123
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41003600 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7219-123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Madison, WI
- NPI 1780737288
-
- Clinical Psychologist
- Madison, WI
- NPI 1841370384
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.