Catherine Maxwell, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20010422A Issued in IN

Practice address

53700 Generations Dr
Suite 200
South Bend, IN 46635-1539

Phone

(574) 286-9198

Fax

(574) 258-6307

NPI assigned

Oct 27, 2005

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1578553798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16395 FOX CROSS DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465309200",
            "telephone_number": "574-286-9198",
            "fax_number": "574-258-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53700 GENERATIONS DR",
            "address_2": "SUITE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351539",
            "telephone_number": "574-286-9198",
            "fax_number": "574-258-6307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20010422A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200094370A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTHCARE MIS",
            "identifier": "244355000",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000237327",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon K Matuszkiewicz Bergemann
• Madison Thelein Matyas
• Patricia Matz, SLP
• Maureen Mauzy, MSW
• Vaughn Thomas Mawhinney, PH.D.
• Carol L Mayernick, LMHC
• Cynthia E Mayfield, MD
• Bradley S Mazick, PHD,HSPP
• Jackline Wangui Mburu
• Stacy L MC Dowell, CNS

• Clinical Psychologist in South Bend, IN
• Providers in South Bend, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.