Provider Demographics
NPI:1275699399
Name:BAKER, CYNTHIA ELAINE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ELAINE
Last Name:BAKER
Suffix:
Gender:F
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 1:510 LAVERS CIR APT 161
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-7973
Mailing Address - Country:US
Mailing Address - Phone:573-489-0868
Mailing Address - Fax:
Practice Address - Street 1:14000 S MILITARY TRL STE 202
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-2600
Practice Address - Country:US
Practice Address - Phone:561-884-9095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2023-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003030321951041C0700X
MN323881041C0700X
FL209301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO498358803Medicaid
MO187444OtherBLUE CROSS BLUE SHIELD