Doctor Name: | MR. CRAIG E. MAXIM |
NPI Number: | 1003965872 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHC |
License Number: | 5063 |
Business Practice Address: | 70 Church St Suite 11 Whitinsville, MA - 015881447 |
Business Phone Number: | 5082349150 |
Business Fax Number: | |
Mailing Address: | 94 Clover Hill Rd, WHITINSVILLE |
State: | MA |
Postal Code: | 015882033 |
Phone Number: | 5082347265 |
Fax Number: | |
NPI Enumeration Date: | 01/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 5063 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |