Individual provider · Type 1 NPI
Carly Jae Maxwell
Professional Counselor · Fowler, CA
NPI number
1508652272
Active
Practice location
311 E Merced St
Fowler, CA 93625-2316
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 21227 (CA) |
| Professional Counselor Primary | 101YP2500X | APCC19936 (CA) |
Professional Counselor: Definition to come...
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About NPI 1508652272
Carly Jae Maxwell's National Provider Identifier is 1508652272, issued on Apr 17, 2025. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Fowler, CA. The record was last updated on Jul 22, 2025.