Individual provider Active NPI

Maxine A Nakai, LISW, LPCC

  • Clinical Social Worker
  • Taos, NM
National Provider Identifier
1467692681
Registry record updated Feb 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-2895 Issued in NM
Practice address
230 Rotten Tree Rd
Taos, NM 87571
Phone
(575) 758-7824
Fax
(575) 758-3346
NPI assigned
Feb 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1856 NM
Clinical Social Worker 1041C0700X I-2895 NM Primary

Addresses

Primary practice location

230 Rotten Tree Rd
Taos, NM 87571

Mailing address

PO Box 1846
230 Rotten Tree Rd
Taos, NM 87571-1846
Phone (575) 758-7824

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
I-2895NMMDClinical Social Worker
1856NMMDOral and Maxillofacial Pathology Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Taos Pueblo CMS Administration Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235692800000",
    "number": "1467692681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1846",
            "address_2": "230 ROTTEN TREE RD",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875711846",
            "telephone_number": "575-758-7824",
            "fax_number": "575-758-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 ROTTEN TREE RD",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "87571",
            "telephone_number": "575-758-7824",
            "fax_number": "575-758-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAI",
        "first_name": "MAXINE",
        "middle_name": "A",
        "credential": "LISW, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-27",
        "last_updated": "2009-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "1856",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-2895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.