Provider Demographics
NPI:1942320320
Name:MAKI, STEPHEN ARTHUR (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ARTHUR
Last Name:MAKI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CENTRAL AVE
Mailing Address - Street 2:SUITE 502
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3154
Mailing Address - Country:US
Mailing Address - Phone:406-727-3152
Mailing Address - Fax:406-727-3172
Practice Address - Street 1:410 CENTRAL AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3154
Practice Address - Country:US
Practice Address - Phone:406-727-3152
Practice Address - Fax:406-727-3172
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical