Provider Demographics
NPI:1194036194
Name:BAKER, ERIC W JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:W
Last Name:BAKER
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 GRANT LINE RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-2494
Mailing Address - Country:US
Mailing Address - Phone:812-981-2594
Mailing Address - Fax:
Practice Address - Street 1:3701 TAYLORSVILLE RD STE 2
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1351
Practice Address - Country:US
Practice Address - Phone:502-303-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)