Provider Demographics
NPI:1982592101
Name:MAKELL, JOHN ALBERT IV (LCSW-A, LSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ALBERT
Last Name:MAKELL
Suffix:IV
Gender:M
Credentials:LCSW-A, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 OLD WILLIAM PENN HWY APT 301
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-4824
Mailing Address - Country:US
Mailing Address - Phone:301-919-0656
Mailing Address - Fax:
Practice Address - Street 1:1630 MILITARY CUTOFF RD STE 108
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5719
Practice Address - Country:US
Practice Address - Phone:910-938-1114
Practice Address - Fax:910-938-1118
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCP0220231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical