| Doctor Name: | MRS. TICHIYA MAXEY |
| NPI Number: | 1013371483 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 149018282 |
| Business Practice Address: | 805 S 17th Ave Maywood, IL - 601531701 |
| Business Phone Number: | 7084502015 |
| Business Fax Number: | |
| Mailing Address: | 2403 S 17th Ave, BROADVIEW |
| State: | IL |
| Postal Code: | 601553905 |
| Phone Number: | 7082882656 |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2016 |
| NPI Last Update Date: | 04/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041S0200X |
| License Number: | 149018282 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |