Provider Demographics
NPI:1730699257
Name:MAKARA, KRISTIN LOUISE (LICSW, MLADC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LOUISE
Last Name:MAKARA
Suffix:
Gender:F
Credentials:LICSW, MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 OVERLOOK DR # C4
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2830
Mailing Address - Country:US
Mailing Address - Phone:603-229-8367
Mailing Address - Fax:603-213-6778
Practice Address - Street 1:3 OVERLOOK DR # C4
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2830
Practice Address - Country:US
Practice Address - Phone:603-229-8367
Practice Address - Fax:603-213-6778
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH20531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical