Provider Demographics
NPI:1417269135
Name:GOODIS BAKER INC
Entity Type:Organization
Organization Name:GOODIS BAKER INC
Other - Org Name:CLAIRE GOODIS-BAKER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOODIS-BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC CAC II
Authorized Official - Phone:303-782-0448
Mailing Address - Street 1:1660 S ALBION ST
Mailing Address - Street 2:SUITE 309
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4008
Mailing Address - Country:US
Mailing Address - Phone:303-782-0448
Mailing Address - Fax:303-782-0493
Practice Address - Street 1:1660 S ALBION ST
Practice Address - Street 2:SUITE 309
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4008
Practice Address - Country:US
Practice Address - Phone:303-782-0448
Practice Address - Fax:303-782-0493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-10
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3971101YA0400X
CO1545101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty