Provider Demographics
NPI:1437507944
Name:BAKER, JULIE MICHELLE (LMFT, LPCC)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:MICHELLE
Last Name:BAKER
Suffix:
Gender:F
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16350 BRUCE B DOWNS BLVD # 48814
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3207
Mailing Address - Country:US
Mailing Address - Phone:916-580-7884
Mailing Address - Fax:
Practice Address - Street 1:18311 HIGHWOODS PRESERVE PKWY UNIT 3205
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1910
Practice Address - Country:US
Practice Address - Phone:916-580-7884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5399101YM0800X
FLMT3674101YM0800X, 106H00000X
CA104578106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL84-2672606OtherIRS