Chelsie Maynard, MDIV, LICSW/LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

096151 Issued in NY

Practice address

304 Hoffman St
Elmira, NY 14905-2263

Phone

(607) 425-0050

NPI assigned

Sep 17, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

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 and National Provider Directory roles.

• Family Services of Chemung County, Inc.

  • Counselor
  • Elmira, NY
  • NPI 1619922432
  Medicare reassignment NPD

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1689076044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 W 1ST ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052210",
            "telephone_number": "607-425-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 HOFFMAN ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052263",
            "telephone_number": "607-425-0050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "729 W 1st St",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "NY",
            "postal_code": "149052210",
            "country_code": "US",
            "telephone_number": "607-425-0050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "CHELSIE",
        "credential": "MDIV, LICSW/LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "121193",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Matthews
• Dawn Mattice
• Roberto Mauri, M.D.
• Richard William Maxwell, PHD
• Chelsea Renee Maycumber, AGNP
• Therese Maynard
• Bruno Robert Mazza, MD
• Ryan Michael McAtee, D.O.
• Caleb McCaig
• Joseph McCarty, PHARMD

• Clinical Social Worker in Elmira, NY
• Providers in Elmira, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.