NICOLE MAXWELL – Counseling Psychologist, NPI 1134977127

NICOLE MAXWELL is a healthcare provider. based in Sycamore, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold a License No. 071011214 (IL). The NPI Number for NICOLE MAXWELL is 1134977127

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE MAXWELL
NPI
1134977127
Phone
(779) 777-7335
Address
1625 BETHANY RD
Enumeration Date
7 May 2024
Last Update Date
7 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8157588400
Graduation Year
2018 (8 years ago)
PAC ID
4880139294
Group Practice PAC ID
4981736550
Professional Enrollment ID
I20240710001741
Address ID
IL601783176SY2540XDRXX402
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

Provider Addresses for NICOLE MAXWELL

  • 1625 BETHANY RD

    SYCAMORE, IL 601783124

    Phone: (779) 777-7335

    Type: Mailing

  • 2100 Huntington Dr N Ste B

    Algonquin, IL 601025940

    Phone: (777) 779-7335

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240710001741IClinical PsychologistILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60178)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4981736550View full group profile
NameSpecialtyState
Clinical Social WorkerIL
Mental Health CounselorIL
Mental Health CounselorIL
Mental Health CounselorIL
Clinical PsychologistIL
Nurse PractitionerIL
Nurse PractitionerIL
Clinical PsychologistIL
Mental Health CounselorIL
-IL

Reviews

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Frequently asked questions

Does NICOLE MAXWELL share an NPI with anyone else?
NPI numbers are unique to each provider or organization — NICOLE MAXWELL uses 1134977127.
Does CMS list NICOLE MAXWELL as active?
Yes — NICOLE MAXWELL is active in the NPI listing used on this page.
What is NICOLE MAXWELL's primary classification?
Counseling Psychologist is the headline specialty for NICOLE MAXWELL here. Clinical services aligned with this taxonomy classification.
What address line appears for NICOLE MAXWELL?
NICOLE MAXWELL's geographic hint is Sycamore, Illinois in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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