Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Maxwell Jared Church, CMT

Individual provider Counselor · NPI 1578849022

Maxwell Jared Church, CMT is a Counselor in Santa Rosa, California. Practices as a sole proprietor. Registered with an NPI since 2011.

In the registry since
2011
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Practice location Address checks out

634 Pressley St
Santa Rosa, CA 95404-5526
Phone: (707) 573-6955
Fax: (707) 543-8176
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence NONE

Record details

NPI number1578849022
Entity typeIndividual (Type 1)
GenderMale
Credentials CMT
Sole proprietorYes
NPI enumeratedOctober 28, 2011
Last updated in NPPESOctober 28, 2011

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