Provider Demographics
NPI:1740685379
Name:MAKOWSKI, MARYA SUZANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARYA
Middle Name:SUZANNE
Last Name:MAKOWSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15800 SEAGOVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75253-5703
Mailing Address - Country:US
Mailing Address - Phone:972-892-7198
Mailing Address - Fax:214-932-7519
Practice Address - Street 1:15800 SEAGOVILLE RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75253-5703
Practice Address - Country:US
Practice Address - Phone:972-892-7198
Practice Address - Fax:765-742-8272
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-24
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33006734A104100000X
TX399341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker