Active NPI
Maximal Living, LLC
- Psychologist
- Philadelphia, PA
National Provider Identifier
1629669692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 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 DirectoryLocations
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.