Healthcare Provider Details

I. General information

NPI: 1184548208
Provider Name (Legal Business Name): MYJA MAKI COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3778 N 39TH ST
BOISE ID
83703-4514
US

IV. Provider business mailing address

3778 N 39TH ST
BOISE ID
83703-4514
US

V. Phone/Fax

Practice location:
  • Phone: 208-861-1050
  • Fax:
Mailing address:
  • Phone: 208-861-1050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MYJA MAKI
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LMSW
Phone: 208-861-1050