Provider Demographics
NPI:1205188703
Name:MAKI, TRISHA LYNN (CAC III)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:LYNN
Last Name:MAKI
Suffix:
Gender:F
Credentials:CAC III
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:LYNN
Other - Last Name:TRICKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8407 N. BRYANT ST.
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031
Mailing Address - Country:US
Mailing Address - Phone:303-487-7776
Mailing Address - Fax:303-487-7868
Practice Address - Street 1:8407 N. BRYANT ST.
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031
Practice Address - Country:US
Practice Address - Phone:303-487-7776
Practice Address - Fax:303-487-7868
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7229101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health