Active NPI
Carol J Maker, PLMHP
- Mental Health Counselor
- South Sioux City, NE
National Provider Identifier
1073701629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 7498
- Practice address
- 625 E 39TH St
South Sioux City, NE 68776-3445 - Phone
- (402) 494-0040
- Fax
- (402) 494-0050
- NPI assigned
- Oct 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 7498 | NE | Primary |
Addresses
Primary practice location
625 E 39TH St
South Sioux City, NE 68776-3445
Mailing address
625 E 39TH St
South Sioux City, NE 68776-3445
Phone (402) 494-0040
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 74306484826 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7498 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191888000000",
"number": "1073701629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 E 39TH ST",
"city": "SOUTH SIOUX CITY",
"state": "NE",
"postal_code": "687763445",
"telephone_number": "402-494-0040",
"fax_number": "402-494-0050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 E 39TH ST",
"city": "SOUTH SIOUX CITY",
"state": "NE",
"postal_code": "687763445",
"telephone_number": "402-494-0040",
"fax_number": "402-494-0050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAKER",
"first_name": "CAROL",
"middle_name": "J",
"credential": "PLMHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-09",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "7498",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "74306484826",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Sioux City, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.