Provider Demographics
NPI:1245407782
Name:SYMES, BAKER DAVID (LPC)
Entity Type:Individual
Prefix:MR
First Name:BAKER
Middle Name:DAVID
Last Name:SYMES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 CATALINA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-3121
Mailing Address - Country:US
Mailing Address - Phone:314-962-7432
Mailing Address - Fax:
Practice Address - Street 1:9137 OLD BONHOMME RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-4417
Practice Address - Country:US
Practice Address - Phone:314-997-7002
Practice Address - Fax:314-997-6848
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000786101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional