Healthcare Provider Details

I. General information

NPI: 1275071987
Provider Name (Legal Business Name): SARAH MAXWELL LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2017
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 WASHINGTON ST
OTSEGO MI
49078-1266
US

IV. Provider business mailing address

3403 102ND AVE
GOBLES MI
49055-8857
US

V. Phone/Fax

Practice location:
  • Phone: 269-694-7873
  • Fax:
Mailing address:
  • Phone: 269-370-4020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801100370
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: