Provider Demographics
NPI:1295044196
Name:BAKER-NEWBERY, DOREE (MS, CAC III, MAC,)
Entity Type:Individual
Prefix:
First Name:DOREE
Middle Name:
Last Name:BAKER-NEWBERY
Suffix:
Gender:F
Credentials:MS, CAC III, MAC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2885 AURORA AVE STE 24
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2251
Mailing Address - Country:US
Mailing Address - Phone:303-443-7695
Mailing Address - Fax:
Practice Address - Street 1:2885 AURORA AVE STE 24
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2251
Practice Address - Country:US
Practice Address - Phone:303-443-7695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1040101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health