Maxwell Francis Chisholm, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801100918 Issued in MI

Practice address

10575 Morang Dr
Detroit, MI 48224-1880

Phone

(517) 673-0021

NPI assigned

Aug 28, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Maxwell Chisholm, LLC

  • Clinical Social Worker
  • Ypsilanti, MI
  • NPI 1245952464
  NPD Authorized official
• Livingston County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Howell, MI
  • NPI 1346313731
  NPD (past)

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1801313119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 TERRACE LN",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481983063",
            "telephone_number": "517-673-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10575 MORANG DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482241880",
            "telephone_number": "517-673-0021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Victors Way Ste 10",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481085220",
            "country_code": "US",
            "telephone_number": "734-973-6779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "MAXWELL",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-28",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801100918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346313731",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Elizabeth Chipungu, PH.D.
• Jennifer Chirgwin, MSW
• Chiropractic 4 Life
• Babysarojini Chirumamilla, M.D
• April Dawn Chisholm, M.S.
• Tahnia Chism
• Darrell Chisolm
• Kailey McGregor Chisolm, PA-C
• Dhananjay Arun Chitale
• Meera B Chitlur, MD

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.