Provider Demographics
NPI:1104713684
Name:BAKER, JESSE LEVI (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:JESSE
Middle Name:LEVI
Last Name:BAKER
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 VALLEY ST UNIT 24
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-5672
Mailing Address - Country:US
Mailing Address - Phone:401-226-9999
Mailing Address - Fax:
Practice Address - Street 1:426 SCRABBLETOWN RD STE C
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-3649
Practice Address - Country:US
Practice Address - Phone:401-477-9922
Practice Address - Fax:401-477-9922
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW041031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical