Provider Demographics
NPI:1619989845
Name:MAKOWSKI, MICHAEL JOSEPH (MSW, ACSW, LISW, BCD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:MAKOWSKI
Suffix:
Gender:M
Credentials:MSW, ACSW, LISW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4859 DOVER CENTER RD
Mailing Address - Street 2:SUITE #9
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-3184
Mailing Address - Country:US
Mailing Address - Phone:440-779-8880
Mailing Address - Fax:440-779-9559
Practice Address - Street 1:4859 DOVER CENTER RD
Practice Address - Street 2:SUITE #9
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-3184
Practice Address - Country:US
Practice Address - Phone:440-779-8880
Practice Address - Fax:440-779-9559
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00017651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW00901Medicare ID - Type UnspecifiedMEDICARE PROVIDER