Provider Demographics
NPI:1356050785
Name:MACLIN, MAYA P (LCPC)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:P
Last Name:MACLIN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22337 REDONDO DRIVE, RICHTON PARK, IL
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471
Mailing Address - Country:US
Mailing Address - Phone:773-603-7421
Mailing Address - Fax:
Practice Address - Street 1:22337 REDONDO DRIVE, RICHTON PARK, IL
Practice Address - Street 2:
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471
Practice Address - Country:US
Practice Address - Phone:773-603-7421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.014663101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional