Individual provider Active NPI

Cara Maksimow, LCSW

  • Clinical Social Worker
  • Chatham, NJ
National Provider Identifier
1346678885
Registry record updated Oct 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC04629900 Issued in NJ
Practice address
21 Coleman Ave E
Chatham, NJ 07928-2243
Phone
(908) 337-6339
NPI assigned
Oct 18, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC04629900 NJ Primary

Addresses

Primary practice location

21 Coleman Ave E
Chatham, NJ 07928-2243

Mailing address

21 Coleman Ave E
Chatham, NJ 07928-2243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 2, 2024 through Jan 2, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SC04629900NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382054400000",
    "number": "1346678885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 COLEMAN AVE E",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 COLEMAN AVE E",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282243",
            "telephone_number": "908-337-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKSIMOW",
        "first_name": "CARA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-18",
        "last_updated": "2013-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04629900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatham, NJ

Sources for this page

Verify at the official NPI Registry.