MEDICARE: NICHOLE MAXWELL MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	CP5483	NV

General Provider Information

NPI Number	:	1972981207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLE MAXWELL MA

Provider Business Mailing Address
First Line	:	2470 WRONDEL WAY STE 260
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-3701
Country	:	US
Telephone Number	:	775-420-9926
Fax Number	:

Provider Business Practice Location Address
First Line	:	2470 WRONDEL WAY STE 260
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-3701
Country	:	US
Telephone Number	:	775-420-9926
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2015
Last Update Date	:	12/15/2025

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Directions to “ NICHOLE MAXWELL MA” Practice Location

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