Mindy Maxwell

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH00009158 Issued in WA

Practice address

652 SW 150TH Street
Ste a
Burien, WA 98166-9816

Phone

(415) 903-0452

NPI assigned

Nov 30, 2012

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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 and National Provider Directory roles.

• Mindy Maxwell Clinical Services PLLC

  • Community/Behavioral Health Agency
  • Burien, WA
  • NPI 1659875813
  NPD Authorized official

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

{
    "created_epoch": "1354233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1386989432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 SW 150TH STREET, STE A",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "98166",
            "telephone_number": "415-903-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 SW 150TH STREET",
            "address_2": "STE A",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981669816",
            "telephone_number": "415-903-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "MINDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-30",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00009158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley Matenda, RD
• Tiffany E Mathis
• Matthew Tomala DDS MSD PLLC
• Maughan Prosthetic & Orthotic, Inc.
• Peter F Maurice III, M.D.
• Ana Caren Maya Arteaga
• Viktor N Mazurets, DDS
• Eliane Marilyne Mbonde, LPN
• Samwel Mbua, ARNP
• Clarissa McCall, LMHCA

• Mental Health Counselor in Burien, WA
• Providers in Burien, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.