MEDICARE: HIROKO MAKABE LCSW, CASAC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor		NY
2	1041C0700X	Clinical Social Worker	LC50078166	DC
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	M11132005	DC
4	1041C0700X	Clinical Social Worker		NY

General Provider Information

NPI Number	:	1578522652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIROKO MAKABE LCSW, CASAC

Provider Business Mailing Address
First Line	:	19 W 34TH ST PH
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-3006
Country	:	US
Telephone Number	:	718-930-2688
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 W 34TH ST PH
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-3006
Country	:	US
Telephone Number	:	718-930-2688
Fax Number	:

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

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	05/07/2019

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