Active NPI
Maxine Herman, LCSW
- Clinical Social Worker
- Beverly Hills, CA
National Provider Identifier
1609397991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 27410
- Practice address
- 300 S Beverly Dr Ste 203
Beverly Hills, CA 90212-4805 - Phone
- (310) 499-9530
- Fax
- (323) 938-7433
- NPI assigned
- Jun 28, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 27410 | CA | Primary |
Addresses
Primary practice location
300 S Beverly Dr Ste 203
Beverly Hills, CA 90212-4805
Mailing address
300 S Beverly Dr Ste 203
Beverly Hills, CA 90212-4805
Phone (310) 499-9530
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37-1663688 | Other | CA | PSYCHOTHERAPIST IN PRIVATE PRACTICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 23, 2012 through Jan 9, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27410 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1609397991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 S BEVERLY DR STE 203",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902124805",
"telephone_number": "310-499-9530",
"fax_number": "323-938-7433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 S BEVERLY DR STE 203",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902124805",
"telephone_number": "310-499-9530",
"fax_number": "323-938-7433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMAN",
"first_name": "MAXINE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-28",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "27410",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOTHERAPIST IN PRIVATE PRACTICE",
"identifier": "37-1663688",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, CA
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.