1467862599 NPI number — MRS. NICOLE ANN EARLY-MAXSON LCSW

Table of content: MACKENZIE ELIZABETH COOKE PA (NPI 1659943892)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467862599 NPI number — MRS. NICOLE ANN EARLY-MAXSON LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EARLY-MAXSON
Provider First Name:
NICOLE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAXSON
Provider Other First Name:
NICOLE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467862599
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

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

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1171 NORTH 67TH AVE
Provider Second Line Business Practice Location Address:
400
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85308-6801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-938-3323
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/28/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LCSW-12584 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: LCSW 12584 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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