Colleen Davis Maxwell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9883 Issued in WI

Practice address

4027 N Oakland Ave
Shorewood, WI 53211-2356

Phone

(414) 585-1620

NPI assigned

May 19, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

University of Pittsburgh School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychiatric Consultants and Therapists SCGroup PAC ID 5092740985, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Psychiatric Consultants & Therapists, SC

  • Psychologist
  • Milwaukee, WI
  • NPI 1700818119
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1609513704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4027 N OAKLAND AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112356",
            "telephone_number": "414-585-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4027 N OAKLAND AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112356",
            "telephone_number": "414-585-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS MAXWELL",
        "first_name": "COLLEEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michele Donalson, LPC

• Clinical Social Worker in Shorewood, WI
• Providers in Shorewood, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.