Provider Demographics
NPI:1184716680
Name:MAKI, BOBBIN KAY (LCPC)
Entity type:Individual
Prefix:MRS
First Name:BOBBIN
Middle Name:KAY
Last Name:MAKI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:BOBBIN
Other - Middle Name:
Other - Last Name:FIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:410 CENTRAL AVE
Mailing Address - Street 2:#502
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401
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:#502
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401
Practice Address - Country:US
Practice Address - Phone:406-727-3152
Practice Address - Fax:406-727-3172
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT474101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT8037OtherBC BS
MT0253227Medicaid
MT84949OtherHEALTH PARTNERS