Nicole Maxwell

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

071011214 Issued in IL

Practice address

1625 Bethany Rd
Sycamore, IL 60178-3124

Phone

(779) 777-7335

NPI assigned

May 7, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Professional Services in Health Psychology, LTDGroup PAC ID 4981736550, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Professional Services in Health Psychology, LTD

  dba LivingRite, The Center for Behavioral Health, LTD

  • Clinical Psychologist
  • Sycamore, IL
  • NPI 1306078894
  Medicare reassignment Care Compare group NPD
• Three Birds Mental Health Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Sycamore, IL
  • NPI 1144141870
  NPD (past)

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

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1134977127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 BETHANY RD",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783124",
            "telephone_number": "779-777-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 BETHANY RD",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783124",
            "telephone_number": "779-777-7335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Huntington Dr N Ste B",
            "address_purpose": "LOCATION",
            "city": "Algonquin",
            "state": "IL",
            "postal_code": "601025940",
            "country_code": "US",
            "telephone_number": "777-779-7335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IL",
            "license": "071011214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Mathern, PA
• James Michael Matheu, DO
• Koren Mauch, RN
• Heather Lynn Maulson-Breuer, D.M.D
• Helen Jean Maurer, MSW
• MC Risk Assessment Consulting
• Madelena Lucinda McClure, M.S., CCC-SLP, L
• Jennifer McCormick, M.D.
• McCoy Chiropractic, P.C.
• Dwight Matthew McCoy, D.C., C.C.S.P.

• Counseling Psychologist in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Counseling Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.