Provider Demographics
NPI:1548397250
Name:MAXEY, CHRISTY (MC, LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:MAXEY
Suffix:
Gender:F
Credentials:MC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3414 N SILVERADO
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-4302
Mailing Address - Country:US
Mailing Address - Phone:480-634-8717
Mailing Address - Fax:
Practice Address - Street 1:3303 E BASELINE RD
Practice Address - Street 2:SUITE #114
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2738
Practice Address - Country:US
Practice Address - Phone:480-600-3003
Practice Address - Fax:480-545-6773
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10648101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional