Provider Demographics
NPI:1821546557
Name:MCDOWELL, MAXSON JOHN (LMSW, LP)
Entity Type:Individual
Prefix:DR
First Name:MAXSON
Middle Name:JOHN
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:LMSW, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 W 88TH ST
Mailing Address - Street 2:SUITE 9E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1716
Mailing Address - Country:US
Mailing Address - Phone:917-359-3948
Mailing Address - Fax:212-280-1080
Practice Address - Street 1:255 W 88TH ST
Practice Address - Street 2:SUITE 9E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1716
Practice Address - Country:US
Practice Address - Phone:917-359-3948
Practice Address - Fax:212-280-1080
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-11
Last Update Date:2016-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000631-1102L00000X
NY034983-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical