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KRISTIN L MAXWELL PHD, CRC, LCPC
NPI 1164134284
Counselor - Professional in Champaign, IL

Active since December 20, 2022PECOS EnrolledAccepts Medicare Assignment
1802 S MATTIS AVE, CHAMPAIGN, IL 61821(217) 365-2855(217) 383-3439 Get Directions Write a Review

NPPES record last updated: July 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 2, 2025, Dec 20, 2022 (2 updates tracked since 2022).

About Kristin L Maxwell Phd, Crc, Lcpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRISTIN L MAXWELL PHD, CRC, LCPC (NPI 1164134284) is an individual professional provider in Champaign, Illinois, licensed in Illinois (180017061) and active in the NPI registry since December 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1164134284
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKRISTIN L MAXWELLCredential: PHD, CRC, LCPC
Location Address1802 S MATTIS AVEChampaign, IL 61821-5923
Mailing Address611 W Park St, FapcUrbana, IL 61801-2501 · (217) 383-3311
Phone(217) 365-2855
Fax(217) 383-3439
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateDecember 20, 2022
Last NPPES UpdateJuly 2, 20252 updates tracked since enumeration
NPPES CertifiedJune 17, 2025
✔ NPI 1164134284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in IL · 180017061
1802 S MATTIS AVE, Champaign, IL 61821
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kristin L Maxwell Phd, Crc, Lcpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749792232
PECOS Enrollment IDI20250620002681
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHAEL D RUBIN PHD
Psychologist
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 255-9580
CARLE CLINIC ASSOCIATION, PC
Durable Medical Equipment & Medical Supplies
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 326-1220
DR. GABRIEL SOTOMAYOR M.D.
Physical Medicine & Rehabilitation
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 902-6954
KRISTINE S ANDERSON PA
Physician Assistant (Surgical)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 383-3260
DR. JOHN P BAKER PHD
Psychologist
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 365-2855
SELAHATTIN GOKTURK M.A
Social Worker (Clinical)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 383-1850
AMANDA GAUGLER
Social Worker (Clinical)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 365-2855
MS. LISA ANNETTE ELLINGWOOD APRN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1802 S MATTIS AVE
CHAMPAIGN, IL 61821
Champaign County (217) 365-2855

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kristin Maxwell's NPI number?

The NPI number for Kristin Maxwell is 1164134284. It was assigned to this individual provider in the NPPES registry on December 20, 2022.

Where is Kristin Maxwell located?

Kristin Maxwell practices at 1802 S Mattis Ave, Champaign, IL 61821. The listed phone number is (217) 365-2855.

What is Kristin Maxwell's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kristin Maxwell enrolled in Medicare?

Yes. Kristin Maxwell is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kristin Maxwell was last updated on July 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.