Provider Demographics
NPI:1225531163
Name:MAKI, MYJA AMELIA (LMSW)
Entity type:Individual
Prefix:MRS
First Name:MYJA
Middle Name:AMELIA
Last Name:MAKI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3778 N 39TH ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-4514
Mailing Address - Country:US
Mailing Address - Phone:208-861-1050
Mailing Address - Fax:
Practice Address - Street 1:7291 W FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-0926
Practice Address - Country:US
Practice Address - Phone:208-323-4400
Practice Address - Fax:208-810-4090
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-413451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical