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General NPI Number Information
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NPI Number | 1922755313
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Entity Type | Individual
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Provider Name | KIMBERLY ANN MCGRATH MAKI MS, LPC
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Gender | Female
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Dates
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Enumeration Date | 03/04/2022
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Last Update Date | 03/04/2022
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Provider Practice Location Address
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Address Line | 420 BOULEVARD STE 207
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City | MOUNTAIN LAKES
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State | NJ
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Zip | 07046-1733
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Country | US
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Telephone | 973-525-3874
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Fax |
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Provider Business Mailing Address
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Address Line | 26B W MAIN ST
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City | MENDHAM
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State | NJ
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Zip | 07945-1217
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Country | US
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Telephone | 973-525-3874
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00827000
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00827000
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License Number State | NJ
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