Provider Demographics
NPI:1659920114
Name:MAXSON, LINDSAY MARIE (DSW, LCSW)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:MAXSON
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HAMMITT DR
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-3251
Mailing Address - Country:US
Mailing Address - Phone:630-220-3216
Mailing Address - Fax:
Practice Address - Street 1:108 HAMMITT DR
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-3251
Practice Address - Country:US
Practice Address - Phone:630-220-3216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-08
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0216011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty