Individual
DR. CATHERINE MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
53700 GENERATIONS DR, SUITE 200, SOUTH BEND, IN 46635-1539
(574) 286-9198
(574) 258-6307
Mailing address
16395 FOX CROSS DR, GRANGER, IN 46530-9200
(574) 286-9198
(574) 258-6307
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20010422A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000237327
ANTHEM BCBS
IN
05
—
200094370A
—
IN
01
—
244355000
MAGELLAN HEALTHCARE MIS
IN
Enumeration date
10/27/2005
Last updated
07/21/2022
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