Organization
MICHAEL MAKSIMOVICH LCSW LLC
Active
Other names
Michael Maksimovich
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JOHN MAKSIMOVICH LCSW (OWNER/PRESIDENT)
(317) 250-4149
Entity
Organization
Contact information
Practice address
6314 RUCKER RD STE A, INDIANAPOLIS, IN 46220-4800
(317) 250-4149
(317) 465-9689
Mailing address
6314 RUCKER RD STE A, INDIANAPOLIS, IN 46220-4800
(317) 250-4149
(317) 465-9689
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649404377
NPI
IN
Enumeration date
07/31/2023
Last updated
07/31/2023
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