Provider Demographics
NPI:1043504806
Name:BAKERS COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:BAKERS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATREACE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN-BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LPC/S
Authorized Official - Phone:843-379-1003
Mailing Address - Street 1:12 FAIRFIELD RD
Mailing Address - Street 2:SUITE B3
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-2575
Mailing Address - Country:US
Mailing Address - Phone:843-379-1003
Mailing Address - Fax:843-379-0700
Practice Address - Street 1:12 FAIRFIELD RD STE B3
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-2576
Practice Address - Country:US
Practice Address - Phone:843-379-1003
Practice Address - Fax:843-379-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X
SC11727261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP5730Medicaid