MEDICARE: MRS. NICOLE ANN EARLY-MAXSON LCSW

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	1041C0700X	Clinical Social Worker	LCSW-12584	AZ
2	1041C0700X	Clinical Social Worker	LCSW 12584	AZ

General Provider Information

NPI Number	:	1467862599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NICOLE ANN EARLY-MAXSON LCSW

Provider Business Mailing Address
First Line	:	17100 N 67TH AVE STE 400
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-3698
Country	:	US
Telephone Number	:	623-280-8832
Fax Number	:

Provider Business Practice Location Address
First Line	:	1171 NORTH 67TH AVE
Second Line	:	400
City	:	GLENDALE
State	:	AZ
Zip	:	85308-6801
Country	:	US
Telephone Number	:	602-938-3323
Fax Number	:

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

Provider Enumeration Date	:	04/28/2014
Last Update Date	:	02/10/2026

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