MAXWELL SHACK
NPI 1619836020
Counselor - Mental Health in Santa Ana, CA

Active since January 20, 2026
505 N TUSTIN AVE STE 265, SANTA ANA, CA 92705(866) 766-4935 Get Directions Write a Review

NPPES record last updated: January 20, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Maxwell Shack NPPES

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

MAXWELL SHACK (NPI 1619836020) is an individual mental health provider in Santa Ana, California, licensed in California (21497) and active in the NPI registry since January 2026.

NPPES Registry Identity

NPI1619836020
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMAXWELL SHACK
Location Address505 N TUSTIN AVE STE 265Santa Ana, CA 92705-3775
Mailing Address505 N Tustin Ave Ste 265Santa Ana, CA 92705-3775
Sole ProprietorYes
Enumeration DateJanuary 20, 2026
NPPES CertifiedJanuary 20, 2026
NPI 1619836020 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License Licensed in CA · 21497
505 N TUSTIN AVE STE 265, Santa Ana, CA 92705

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

Marriage & Family Therapist
505 N TUSTIN AVE STE 265
SANTA ANA, CA 92705
Marriage & Family Therapist
505 N TUSTIN AVE STE 265
SANTA ANA, CA 92705
Marriage & Family Therapist
505 N TUSTIN AVE STE 265
SANTA ANA, CA 92705
Counselor
505 N TUSTIN AVE STE 265
SANTA ANA, CA 92705

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 Maxwell Shack's NPI number?

The NPI number for Maxwell Shack is 1619836020. It was assigned to this individual provider in the NPPES registry on January 20, 2026.

Where is Maxwell Shack located?

Maxwell Shack practices at 505 N Tustin Ave Ste 265, Santa Ana, CA 92705. The listed phone number is (866) 766-4935.

What is Maxwell Shack's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Maxwell Shack was last updated on January 20, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.