Provider Demographics
NPI:1477726735
Name:MAAKARON, JOHN CHARLES (MA,LLP/CTS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHARLES
Last Name:MAAKARON
Suffix:
Gender:M
Credentials:MA,LLP/CTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51782 FLYER DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-4339
Mailing Address - Country:US
Mailing Address - Phone:586-899-0686
Mailing Address - Fax:
Practice Address - Street 1:36150 DEQUINDRE RD STE 530
Practice Address - Street 2:STE B
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-7142
Practice Address - Country:US
Practice Address - Phone:586-899-0686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJM012480103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical