MEDICARE: MAKIAH D NEW LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	39005902A	IN

General Provider Information

NPI Number	:	1447193057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKIAH D NEW LMHC

Provider Business Mailing Address
First Line	:	445 N CROSS POINTE BLVD
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-4010
Country	:	US
Telephone Number	:	812-471-4611
Fax Number	:	812-471-4514

Provider Business Practice Location Address
First Line	:	PO BOX 632281
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-2281
Country	:	US
Telephone Number	:	812-450-6815
Fax Number	:	812-450-6822

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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