Provider Demographics
NPI:1447580337
Name:BAKER, DENISE CAROL (LCSW)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:CAROL
Last Name: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 1:812 OFFICE PARK CIR
Mailing Address - Street 2:#107
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3167
Mailing Address - Country:US
Mailing Address - Phone:972-436-5157
Mailing Address - Fax:972-436-2570
Practice Address - Street 1:812 OFFICE PARK CIR
Practice Address - Street 2:#107
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3167
Practice Address - Country:US
Practice Address - Phone:972-436-5157
Practice Address - Fax:972-436-2570
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX330341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical