Organization Active NPI

Maximal Living, LLC

  • Psychologist
  • Philadelphia, PA
National Provider Identifier
1629669692
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MAXIMAL LIVING, LLC
Practice address
2005 Market St Ste 3140
Philadelphia, PA 19103-7001
Phone
(215) 665-8189
NPI assigned
Feb 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Authorized official

Name
Faith Dyson-Washington, PH.D.
Title
Psychologist
Phone
(267) 736-9536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

2005 Market St Ste 3140
Philadelphia, PA 19103-7001

Mailing address

3100 Mount Vernon St
Philadelphia, PA 19104-2024
Phone (267) 736-9536

National Provider Directory

National Provider Directory

Locations

2005 Market St
Ste 3140
Philadelphia, PA 19103
Phone (215) 636-9797

NPI Registry JSON

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612137600000",
    "number": "1629669692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MOUNT VERNON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042024",
            "telephone_number": "267-736-9536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 MARKET ST STE 3140",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191037001",
            "telephone_number": "215-665-8189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIMAL LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A",
        "authorized_official_last_name": "DYSON-WASHINGTON",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "267-736-9536",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.