Individual provider Active NPI

Makayla Condie, LCPC, CMHC, LPCC

  • Mental Health Counselor
  • La Verne, CA
National Provider Identifier
1073960795
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13852 Issued in CA
Practice address
3355 N White Ave
#7192
La Verne, CA 91750-7192
Phone
(208) 219-0425
NPI assigned
May 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 13852 CA Primary
Mental Health Counselor 101YM0800X 11697949-6004 UT
Mental Health Counselor 101YM0800X LCPC-7003 ID
Mental Health Counselor 101YM0800X LPC - 6171 ID

Addresses

Primary practice location

3355 N White Ave
#7192
La Verne, CA 91750-7192

Mailing address

3355 N White Ave
#7192
La Verne, CA 91750-7192
Phone (208) 219-0425

Other names 1

  • Makayla Burkman Former name

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

LicenseStateTypeSpecialty
13852CAMDMental Health Counselor
LCPC-7003IDMDMental Health Counselor
LPC - 6171IDMDMental Health Counselor
11697949-6004UTMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1073960795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 N WHITE AVE",
            "address_2": "#7192",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917507192",
            "telephone_number": "208-219-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 N WHITE AVE",
            "address_2": "#7192",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917507192",
            "telephone_number": "208-219-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDIE",
        "first_name": "MAKAYLA",
        "credential": "LCPC, CMHC, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "13852",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "11697949-6004",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-7003",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC - 6171",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAKAYLA",
            "last_name": "BURKMAN",
            "credential": "LCPC, CMHC, LPCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Verne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.