Provider Demographics
NPI:1720842701
Name:MAXIME THERAPY LCSW PLLC
Entity Type:Organization
Organization Name:MAXIME THERAPY LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/CLINICAL SOCIAL WOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:MARGUERITE
Authorized Official - Last Name:MAXIME
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LICSW
Authorized Official - Phone:508-922-2004
Mailing Address - Street 1:6 NARCISSUS ROAD WEST
Mailing Address - Street 2:
Mailing Address - City:MASTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11951
Mailing Address - Country:US
Mailing Address - Phone:508-922-2004
Mailing Address - Fax:855-841-3966
Practice Address - Street 1:808 UNION STREET
Practice Address - Street 2:SUITE 3A, OFFICE 6
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-1121
Practice Address - Country:US
Practice Address - Phone:508-922-2004
Practice Address - Fax:855-841-3966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health