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MS. KRISTINE MAYNARD LCSW
NPI 1215077011
Social Worker - Clinical in La Grange, IL

Active since February 08, 2007Opted out of Medicare · through Jan 16, 2028
1030 S. LA GRANGE RD, STE #9, LA GRANGE, IL 60525(708) 921-3639(708) 588-1501 Get Directions Write a Review

NPPES record last updated: February 3, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Kristine Maynard Lcsw NPPES

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

MS. KRISTINE MAYNARD LCSW (NPI 1215077011) is an individual clinical provider in La Grange, Illinois, licensed in Illinois (149008276) and active in the NPI registry since February 2007. She has opted out of Medicare through January 16, 2028.

NPPES Registry Identity

NPI1215077011
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. KRISTINE MAYNARDCredential: LCSW
Location Address1030 S. LA GRANGE RD, STE #9La Grange, IL 60525
Mailing Address1030 S. La Grange Rd, Ste #9La Grange, IL 60525 · (708) 921-3639 · Fax (708) 588-1501
Phone(708) 921-3639
Fax(708) 588-1501
Sole ProprietorYes
Enumeration DateFebruary 8, 2007
Last NPPES UpdateFebruary 3, 2020
✔ NPI 1215077011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IL · 149008276
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1030 S. LA GRANGE RD, La Grange, IL 60525
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ms. Kristine Maynard Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 16, 2022 through January 16, 2028.

Opt-Out Effective DateJanuary 16, 2022
Opt-Out In Effect ThroughJanuary 16, 2028Opt-out affidavits renew automatically every two years unless cancelled

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 Kristine Maynard's NPI number?

The NPI number for Kristine Maynard is 1215077011. It was assigned to this individual provider in the NPPES registry on February 8, 2007.

Where is Kristine Maynard located?

Kristine Maynard practices at 1030 S. La Grange Rd Ste #9, La Grange, IL 60525. The listed phone number is (708) 921-3639.

What is Kristine Maynard's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kristine Maynard enrolled in Medicare?

No. Kristine Maynard has opted out of Medicare through January 16, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Kristine Maynard was last updated on February 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.