Individual provider Active NPI

Rickey Joe Maxwell, LMFT

  • Marriage & Family Therapist
  • San Marcos, CA
National Provider Identifier
1245368232
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
46750 Issued in CA
Practice address
300 Rancheros Dr Ste 130
San Marcos, CA 92069-2968
Phone
(858) 279-1223
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 46750 CA Primary

Addresses

Primary practice location

300 Rancheros Dr Ste 130
San Marcos, CA 92069-2968

Mailing address

300 Rancheros Dr Ste 130
San Marcos, CA 92069-2968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240603002497 CA Practitioner - Marriage and Family Therapist 0547702813

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46750CAMDDentist

Interoperability endpoints

  • Direct secure messaging: psycareassociates.rickeymaxwell@143255.advancedmd-direct.com

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1245368232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RANCHEROS DR STE 130",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RANCHEROS DR STE 130",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692968",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "RICKEY",
        "middle_name": "JOE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "46750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

Verify at the official NPI Registry.