Maverick Addiction Services, LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

86000039A Issued in IN

Legal business name

MAVERICK ADDICTION SERVICES, LLC

Practice address

35 S State St
Suite 1
North Vernon, IN 47265-1800

Phone

(812) 953-1181

Fax

(812) 953-1158

NPI assigned

Oct 26, 2010

Last updated

Oct 26, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Vickie J Cox, L.A.C. NCAC II...

Title

Ceo & Addiction Counselor

Phone

(812) 953-1181

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1932409729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 951",
            "address_2": "35 S. STATE ST., SUITE 1",
            "city": "NORTH VERNON",
            "state": "IN",
            "postal_code": "472650951",
            "telephone_number": "812-953-1181",
            "fax_number": "812-953-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 S STATE ST",
            "address_2": "SUITE 1",
            "city": "NORTH VERNON",
            "state": "IN",
            "postal_code": "472651800",
            "telephone_number": "812-953-1181",
            "fax_number": "812-953-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVERICK ADDICTION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO & ADDICTION COUNSELOR",
        "authorized_official_telephone_number": "812-953-1181",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.A.C. NCAC II..."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "86000039A",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyra A Littrell, LMHC, LCAC
• Olivia Ann Lux, OD
• Sarah Mann, CRNA
• Destiny Marcum, BS, CADAC II
• Kendra Martin, MSSW, LCSW
• Max a Henry MD
• Kara May, PTA
• Ashly Nichole McDonald
• Melissa R Hunter LMHC LLC
• Mid America Clinical Laboratories, LLC

• Addiction (Substance Use Disorder) Counselor in North Vernon, IN
• Providers in North Vernon, IN by specialty
• Addiction (Substance Use Disorder) Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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.