Individual provider Active NPI

Maxine Swajian

  • Mental Health Counselor
  • Cranston, RI
National Provider Identifier
1174080717
Registry record updated Mar 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
100 Midway Rd Ste 9
Cranston, RI 02920-5742
Phone
(646) 389-8330
NPI assigned
Mar 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

100 Midway Rd Ste 9
Cranston, RI 02920-5742

Mailing address

100 Midway Rd Ste 9
Cranston, RI 02920-5742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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

Enrollment IDStateProvider typePAC IDDetails
I20240205003696 RI Practitioner - Mental Health Counselor 5698118834 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical of Michigan PC CurrentSince Jan 1, 2024 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

555 N Main St
Providence, RI 02904
Phone (401) 376-3093

3804 Wilson Blvd
#1318
Arlington, VA 22203

Organizations & group practices 1

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": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551398400000",
    "number": "1174080717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MIDWAY RD STE 9",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029205742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MIDWAY RD STE 9",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029205742",
            "telephone_number": "646-389-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAJIAN",
        "first_name": "MAXINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-01",
        "last_updated": "2019-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.