Provider Demographics
NPI:1225378151
Name:BAKER, KAREN (LPC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8911 N 70TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-2111
Mailing Address - Country:US
Mailing Address - Phone:414-553-1154
Mailing Address - Fax:414-433-1833
Practice Address - Street 1:8532 W CAPITOL DR STE 201
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1850
Practice Address - Country:US
Practice Address - Phone:414-553-1154
Practice Address - Fax:414-433-1833
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-01
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP1600X
WI6140-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100029488Medicaid