Max Marie McIntosh, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4102 Issued in NC

Practice address

2910 Briarcliff Rd
Suite B
Winston-Salem, NC 27106-3077

Phone

(336) 682-3519

Fax

(336) 773-0332

NPI assigned

Jun 16, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• LSBF Professional Counseling Services, PLLC

  • Community/Behavioral Health Agency
  • Winston Salem, NC
  • NPI 1497453187
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NC, Professional

  Medicare reassignment NPD
• Trauma Recovery, LLC

  • Professional Counselor
  • Winston Salem, NC
  • NPI 1033476825
  NPD (past) Authorized official

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972547941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5025 ELTHA DR",
            "address_2": "APT. G",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271051112",
            "telephone_number": "336-682-3519",
            "fax_number": "336-773-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 BRIARCLIFF RD",
            "address_2": "SUITE B",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271063077",
            "telephone_number": "336-682-3519",
            "fax_number": "336-773-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "MAX",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103082",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCC",
            "identifier": "67403",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "4102",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David McIlwain
• Joseph McIlwain
• Laura Lyn McIlwain, PA-C
• Lahniah McInnis
• Lindsey Nicole McInnis
• Paulisha Da-Shawna McIntyre, BSW, MSW, LCSW-A
• Lisa Gayle McIver, FNP-C
• Zachariah McIver, DO
• John Thomas McKay, D.O.
• Lauren Elizabeth-Kraics McKay, DO

• Professional Counselor in Winston-Salem, NC
• Providers in Winston-Salem, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.