MEDICARE: CHRISTINA MAXWELL LPC ASSOCIATE

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	101Y00000X	Counselor	90959	TX

General Provider Information

NPI Number	:	1811698632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA MAXWELL LPC ASSOCIATE

Provider Business Mailing Address
First Line	:	17214 SADDLEHORN
Second Line	:
City	:	NEW CANEY
State	:	TX
Zip	:	77357-4726
Country	:	US
Telephone Number	:	281-785-7738
Fax Number	:

Provider Business Practice Location Address
First Line	:	1306 KINGWOOD DR STE I
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-3150
Country	:	US
Telephone Number	:	281-973-4567
Fax Number	:

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

Provider Enumeration Date	:	03/17/2023
Last Update Date	:	03/17/2023

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