Individual
CHAD MICHEAL MAXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS, CAC
Contact information
Practice address
2165 PROMISE RD, RAPID CITY, SD 57701-8981
(605) 718-1095
Mailing address
2165 PROMISE RD, RAPID CITY, SD 57701-8981
(605) 718-1095
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
26022072
SD
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17091759
SD
Other
Enumeration date
09/27/2023
Last updated
03/04/2026
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