Provider Demographics
NPI:1376636209
Name:BAKER, DOROTHY B (LPC)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:B
Last Name:BAKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:B
Other - Last Name:WARE OR BAJGERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2526
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64803-2526
Mailing Address - Country:US
Mailing Address - Phone:417-347-7600
Mailing Address - Fax:417-347-7608
Practice Address - Street 1:2934 MC CLELLAND BLVD
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1632
Practice Address - Country:US
Practice Address - Phone:417-347-7580
Practice Address - Fax:417-347-7582
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002150101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional