Provider Demographics
NPI:1346434172
Name:BAKER, CARRIE KERR (MSW)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:KERR
Last Name:BAKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 PAGE ST
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:MA
Mailing Address - Zip Code:02322-1001
Mailing Address - Country:US
Mailing Address - Phone:413-557-2623
Mailing Address - Fax:
Practice Address - Street 1:WESTOVER AIR RESERVE BASE
Practice Address - Street 2:390 WALKER AVE, BLDG #2235
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01022-1534
Practice Address - Country:US
Practice Address - Phone:413-557-2623
Practice Address - Fax:413-557-2657
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066259-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical