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General NPI Number Information
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NPI Number | 1578043477
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Entity Type | Individual
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Provider Name | OCTOBER EVANS MAKABIN LCSW(A)-1041C0700X
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Gender | Female
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Dates
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Enumeration Date | 08/20/2018
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Last Update Date | 11/06/2018
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Provider Practice Location Address
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Address Line | 327 1ST AVE NW
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City | HICKORY
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State | NC
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Zip | 28601-6122
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Country | US
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Telephone | 828-695-5900
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Fax | 828-695-4256
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Provider Business Mailing Address
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Address Line | 4121 CASTLETON RD APT A
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City | CHARLOTTE
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State | NC
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Zip | 28211-2532
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Country | US
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Telephone | 980-365-0770
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P012751
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License Number State | NC
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