Provider Demographics
NPI:1801407895
Name:RABINOWE, MAXINE FRAN (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:MAXINE
Middle Name:FRAN
Last Name:RABINOWE
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1943 N SUMMIT AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1386
Mailing Address - Country:US
Mailing Address - Phone:262-498-4541
Mailing Address - Fax:
Practice Address - Street 1:1943 N SUMMIT AVE APT 14
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-1386
Practice Address - Country:US
Practice Address - Phone:262-498-4541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1039461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty