Healthcare Provider Details

I. General information

NPI: 1154244473
Provider Name (Legal Business Name): MAXINE CUVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6419 BANNINGTON RD STE B
CHARLOTTE NC
28226-1341
US

IV. Provider business mailing address

2250 HAWKINS ST UNIT 458
CHARLOTTE NC
28203-6763
US

V. Phone/Fax

Practice location:
  • Phone: 704-859-0355
  • Fax:
Mailing address:
  • Phone: 855-280-7688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23281
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: