Active NPI
Maxine Miesak Carr, PSYD
- Clinical Psychologist
- Mount Prospect, IL
National Provider Identifier
1134008949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.011315
- Practice address
- 800 E Northwest Hwy Ste 206
Mt Prospect, IL 60056-3457 - Phone
- (301) 351-7287
- NPI assigned
- Aug 27, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 Psychologist | 103TC0700X | 071.011315 | IL | Primary |
Addresses
Primary practice location
800 E Northwest Hwy Ste 206
Mt Prospect, IL 60056-3457
Mailing address
1013 Walthour Rd
Savannah, GA 31410-2817
Phone (301) 351-7287
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.011315 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756771200000",
"number": "1134008949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1013 WALTHOUR RD",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314102817",
"telephone_number": "301-351-7287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E NORTHWEST HWY STE 206",
"city": "MT PROSPECT",
"state": "IL",
"postal_code": "600563457",
"telephone_number": "301-351-7287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARR",
"first_name": "MAXINE",
"middle_name": "MIESAK",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-27",
"last_updated": "2025-09-02",
"certification_date": "2025-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.011315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Prospect, IL
- Caremark, L.L.C. (Caremark Illinois Specialty Pharmacy, LLC)
- Caring Heart Home Hospice Inc
- Deanna Carlson, PTA
- Carmen Garcia Podiatry, P.C.
- Margaret Carnes, PHARM D RPH
- Ashley J Carranza
- Camille Carso
- Center for Comprehensive Services, Inc (Neurorestorative Illinois)
- Center for Comprehensive Services, Inc (Neurorestorative Illinois)
- Center for Comprehensive Services, Inc (Neurorestorative Illinois)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.