Individual
MR. MICHAEL J MAKSIMOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6314 RUCKER ROAD SUITE A, INDIANAPOLIS, IN 46220
(317) 250-4149
Mailing address
6314 RUCKER ROAD SUITE A, INDIANAPOLIS, IN 46220
(317) 250-4149
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005717A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033890157
TYPE II NPI
IN
Enumeration date
05/09/2009
Last updated
03/20/2024
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