Provider Demographics
NPI:1497637177
Name:SINGLETON, MAXIMILIAN W
Entity type:Individual
Prefix:MR
First Name:MAXIMILIAN
Middle Name:W
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 LA CRUZ RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-1236
Mailing Address - Country:US
Mailing Address - Phone:505-930-9845
Mailing Address - Fax:
Practice Address - Street 1:500 4TH ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-5324
Practice Address - Country:US
Practice Address - Phone:505-356-7650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician