NPIMap

Organization Active NPI

Maxus

  • Mental Health Counselor
  • Conway, AR
National Provider Identifier
1912022096
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MAXUS
Practice address
1100 Bob Courtway Dr
Suite 9
Conway, AR 72032-4766
Phone
(501) 328-5525
Fax
(501) 328-5342
NPI assigned
Mar 20, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 Counselor 101YM0800X AR Primary

Addresses

Primary practice location

1100 Bob Courtway Dr
Suite 9
Conway, AR 72032-4766

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Maxus7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1912022096",
    "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": "1100 BOB COURTWAY DR",
            "address_2": "SUITE 9",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324766",
            "telephone_number": "501-328-5525",
            "fax_number": "501-328-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2022-07-21",
        "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": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.