Provider Demographics
NPI:1205992674
Name:MAKKI, MAY H (LCSW-R)
Entity type:Individual
Prefix:MRS
First Name:MAY
Middle Name:H
Last Name:MAKKI
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7119 SHORE RD APT 3K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1832
Mailing Address - Country:US
Mailing Address - Phone:917-886-4854
Mailing Address - Fax:718-836-4213
Practice Address - Street 1:478 BAY RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-2724
Practice Address - Country:US
Practice Address - Phone:347-618-9060
Practice Address - Fax:718-836-4213
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2017-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR046287-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02088984Medicaid
NYP1070627OtherOXFORD
NY125666OtherVALUE OPTIONS
NYNX7431OtherBLUE CROSS BLUE SHIELD
NYN6K121Medicare ID - Type Unspecified