Active NPI
Makayla Condie, LCPC, CMHC, LPCC
- Mental Health Counselor
- La Verne, CA
National Provider Identifier
1073960795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 13852
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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 |
|---|---|---|---|
| 13852 | CA | MD | Mental Health Counselor |
| LCPC-7003 | ID | MD | Mental Health Counselor |
| LPC - 6171 | ID | MD | Mental Health Counselor |
| 11697949-6004 | UT | MD | Mental 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.