Provider Demographics
NPI:1376883561
Name:SKLAR-BAKER, BETH (LCSW)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:SKLAR-BAKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 COLLINWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1035
Mailing Address - Country:US
Mailing Address - Phone:973-313-1803
Mailing Address - Fax:
Practice Address - Street 1:28 MILLBURN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1039
Practice Address - Country:US
Practice Address - Phone:973-313-1803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC495941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical