Provider Demographics
NPI:1780676825
Name:MAXWELL, BARBARA LYNN (LMSW)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LYNN
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1939 S 62ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2138
Mailing Address - Country:US
Mailing Address - Phone:402-616-5975
Mailing Address - Fax:
Practice Address - Street 1:19696 OLD LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-0301
Practice Address - Country:US
Practice Address - Phone:712-325-1331
Practice Address - Fax:712-325-1345
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1863104100000X
IA063181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical