Maxwell Family Therapy Services, Inc

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

MAXWELL FAMILY THERAPY SERVICES, INC

Practice address

2851 Camino del Rio S Ste 300
San Diego, CA 92108-3814

Phone

(619) 664-4606

NPI assigned

Nov 17, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Mark Maxwell, PSYD, LMFT #80504NPI 1205384401

Title

Director

Phone

(619) 664-4606

Specialties & licenses 1

Addresses

Other names 1

• Pacifica Group Counseling and Wellness Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Maxwell, PSY.D, MFT #80504

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1205384401
  NPD Authorized official

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1891452595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 CAMINO DEL RIO S STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083814",
            "telephone_number": "619-664-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 CAMINO DEL RIO S STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083814",
            "telephone_number": "619-664-4606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 Landis Ave",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919102609",
            "country_code": "US",
            "telephone_number": "619-664-4606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAXWELL FAMILY THERAPY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "619-664-4606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LMFT #80504"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacifica Group Counseling and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maxine Dumser, LMFT Family Therapy Services Inc
• Eva J Maxion, MSW, LCSW
• Jennifer Maxon
• Kimberly Ann Maxon, M.D.
• Terry L. Maxson, LCSW
• Tori Maxwell-Pasanen
• Christopher Anthony Maxwell, M.D.
• Christopher D. Maxwell
• Emily Marie Maxwell, PT, DPT
• Kathryn P Maxwell, M.D.

• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.