Active NPI
David Michael Maxwell, M.A.
- Psychologist
- Birmingham, MI
National Provider Identifier
1962711960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301005015
- Practice address
- 770 Forest Ave
Birmingham, MI 48009-6431 - Phone
- (248) 594-3410
- Fax
- (248) 594-3424
- NPI assigned
- Sep 25, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301005015 | MI | Primary |
| School Psychologist | 103TS0200X | CC-0C1870539340 | MI |
Addresses
Primary practice location
770 Forest Ave
Birmingham, MI 48009-6431
Mailing address
770 Forest Ave
Birmingham, MI 48009-6431
Phone (248) 594-3410
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301005015 | MI | MD | Psychologist |
| CC-0C1870539340 | MI | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285372800000",
"number": "1962711960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "770 FOREST AVE",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480096431",
"telephone_number": "248-594-3410",
"fax_number": "248-594-3424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 FOREST AVE",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480096431",
"telephone_number": "248-594-3410",
"fax_number": "248-594-3424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXWELL",
"first_name": "DAVID",
"middle_name": "MICHAEL",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-25",
"last_updated": "2010-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301005015",
"primary": true
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "MI",
"license": "CC-0C1870539340",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.