Provider Demographics
NPI:1003821976
Name:BAER, BROOKS WILLIAM (LCPC)
Entity Type:Individual
Prefix:MR
First Name:BROOKS
Middle Name:WILLIAM
Last Name:BAER
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0012
Mailing Address - Country:US
Mailing Address - Phone:406-543-7271
Mailing Address - Fax:
Practice Address - Street 1:902 N ORANGE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-2928
Practice Address - Country:US
Practice Address - Phone:406-327-3034
Practice Address - Fax:406-327-3385
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT776101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional