Individual provider Active NPI

Maximanova O'Reilly Greenberg, AACR

  • Social Worker
  • Seattle, WA
National Provider Identifier
1235613514
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
CG60707090 Issued in WA
Practice address
10700 Meridian Ave N Ste G11
Seattle, WA 98133-9008
Phone
(206) 461-4544
Fax
(206) 461-6939
NPI assigned
Sep 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CG60707090 WA Primary

Addresses

Primary practice location

10700 Meridian Ave N Ste G11
Seattle, WA 98133-9008

Mailing address

10700 Meridian Ave N Ste G11
Seattle, WA 98133-9008
Phone (206) 361-3020

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

LicenseStateTypeSpecialty
CG60707090WAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Psychiatric Clinic Inc Past Accepting new patients
Sound PastSince Aug 19, 2020 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": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1235613514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 MERIDIAN AVE N STE G11",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981339008",
            "telephone_number": "206-361-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 MERIDIAN AVE N STE G11",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981339008",
            "telephone_number": "206-461-4544",
            "fax_number": "206-461-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "MAXIMANOVA",
        "middle_name": "O'REILLY",
        "credential": "AACR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "CG60707090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; 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.