Provider Demographics
NPI:1164617437
Name:BAKER MILLER, NANCY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:BAKER MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 APPLECREST DR
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-8310
Mailing Address - Country:US
Mailing Address - Phone:207-671-0478
Mailing Address - Fax:
Practice Address - Street 1:45 FOREST FALLS DR
Practice Address - Street 2:SUITE B2
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6999
Practice Address - Country:US
Practice Address - Phone:207-671-0478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC53151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical