Individual provider Active NPI

Maximillian Alexander Hamke, MA, LPC

  • Counselor
  • Madison, AL
National Provider Identifier
1447733167
Registry record updated Feb 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC05504 Issued in AL
Practice address
9694 Madison Blvd Ste A10
Madison, AL 35758-9137
Phone
(256) 203-6558
NPI assigned
Sep 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC05504 AL Primary

Addresses

Primary practice location

9694 Madison Blvd Ste A10
Madison, AL 35758-9137

Mailing address

26 Queensland Dr SW
Huntsville, AL 35824-4114
Phone (916) 320-9041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: No
  • 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
I20250508000404 AL Practitioner - Mental Health Counselor 5395262877 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Raven Heart, LLC Counselor CurrentSince Feb 9, 2025 Accepting new patients
Wellstone, Inc. Mental Health CurrentSince Jan 11, 2025 Accepting new patients

Locations

4040 Memorial Pkwy SW
Huntsville, AL 35802
Phone (256) 533-1970

9694 Madison Blvd
Ste A10
Madison, AL 35758
Phone (256) 203-6558

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": "1536451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738454400000",
    "number": "1447733167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 QUEENSLAND DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358244114",
            "telephone_number": "916-320-9041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9694 MADISON BLVD STE A10",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357589137",
            "telephone_number": "256-203-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMKE",
        "first_name": "MAXIMILLIAN",
        "middle_name": "ALEXANDER",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-09",
        "last_updated": "2025-02-02",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AL",
            "license": "LPC05504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.