NPIMap

Organization Active NPI

Maxus

  • Mental Health Counselor
  • Malvern, AR
National Provider Identifier
1689798993
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MAXUS
Practice address
132 W 2ND St
Malvern, AR 72104-3708
Phone
(501) 776-1191
Fax
(501) 776-1194
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ted Shul
Title
Ceo
Phone
(870) 647-2541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X AR Primary

Addresses

Primary practice location

132 W 2ND St
Malvern, AR 72104-3708

Mailing address

1033 Old Burr Rd
Warm Springs, AR 72478-9077
Phone (870) 647-2541

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Counseling Associates6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

132 W 2nd St
Malvern, AR 72104
Phone (501) 776-1191

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689798993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 OLD BURR RD",
            "city": "WARM SPRINGS",
            "state": "AR",
            "postal_code": "724789077",
            "telephone_number": "870-647-2541",
            "fax_number": "870-647-2145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 W 2ND ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721043708",
            "telephone_number": "501-776-1191",
            "fax_number": "501-776-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHUL",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-647-2541"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.