Provider Demographics
NPI:1851651004
Name:MAKI, CARRIE LYNN (NCC, PPC-596)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:LYNN
Last Name:MAKI
Suffix:
Gender:F
Credentials:NCC, PPC-596
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 W YELLOWSTONE HWY
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-7507
Mailing Address - Country:US
Mailing Address - Phone:307-233-4280
Mailing Address - Fax:
Practice Address - Street 1:535 W YELLOWSTONE HWY
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-7507
Practice Address - Country:US
Practice Address - Phone:307-233-4280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY596101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional