Active NPI
Katherine M Maxwell, LCSW
- Mental Health Counselor
- Chapel Hill, NC
National Provider Identifier
1629164306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- COO4120
- Practice address
- 901 Willow Drive
Suite 5
Chapel Hill, NC 27514 - Phone
- (919) 932-6684
- NPI assigned
- Oct 4, 2006
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | COO4120 | NC | Primary |
Addresses
Primary practice location
901 Willow Drive
Suite 5
Chapel Hill, NC 27514
Mailing address
406 Brookgreen Drive
Chapel Hill, NC 27516
Phone (919) 969-9677
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6002560 | Medicaid | NC | |
| 133TC | Other | NC | BCBS PROVIDER ID |
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
| License | State | Type | Specialty |
|---|---|---|---|
| COO4120 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629164306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "406 BROOKGREEN DRIVE",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "27516",
"telephone_number": "919-969-9677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 WILLOW DRIVE",
"address_2": "SUITE 5",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "27514",
"telephone_number": "919-932-6684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXWELL",
"first_name": "KATHERINE",
"middle_name": "M",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "COO4120",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6002560",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER ID",
"identifier": "133TC",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chapel Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.