Maxwell St. John, LPC

Individual provider Active NPI Professional Counselor · Hamilton, NJ

NPI 1457084345 · NPPES record last updated Jul 18, 2022

Key facts

NPI
1457084345
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
PC014669 (PA)
Practice address
2312 Whitehorse Mercerville Rd Ste 205
Hamilton, NJ 08619-1953
Phone
(215) 617-0861
NPI assigned
Jul 7, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PC014669PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Mental Health Professional Current
since Aug 28, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC014669 PA Yes

Addresses

Primary practice location

2312 Whitehorse Mercerville Rd Ste 205
Hamilton, NJ 08619-1953

Mailing address

550 W Queen LN
Philadelphia, PA 19144-4052
Phone (180) 557-0157

Other providers in Hamilton, NJ

All providers in Hamilton, NJ · Professional Counselor in New Jersey

Sources for this page

Verify at the official NPI Registry.