Individual provider Active NPI

Christina Elizabeth Maxwell, PSYD, HSPP

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1720244783
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20043040A Issued in IN
Practice address
6337 Hollister Dr Ste 101
Indianapolis, IN 46224-2996
Phone
(317) 682-9279
NPI assigned
Jul 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20043040A IN Primary

Addresses

Primary practice location

6337 Hollister Dr Ste 101
Indianapolis, IN 46224-2996

Mailing address

6337 Hollister Dr Ste 101
Indianapolis, IN 46224-2996
Phone (317) 682-9279

Other identifiers 1

IdentifierTypeStateIssuer
20043040AOtherINPSYD LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
20043040AINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Christina E Maxwell PHD Clinical CurrentSince Nov 24, 2024 Accepting new patients
Maxwell Psychological Services, LLC Clinical PastSince Nov 24, 2024 Accepting new patients

Locations

6337 Hollister Dr
Ste 101
Indianapolis, IN 46224
Phone (317) 289-8855

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1720244783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6337 HOLLISTER DR STE 101",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462242996",
            "telephone_number": "317-682-9279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6337 HOLLISTER DR STE 101",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462242996",
            "telephone_number": "317-682-9279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "CHRISTINA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PSYD, HSPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20043040A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYD  LICENSE",
            "identifier": "20043040A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.