Provider Demographics
NPI:1477629731
Name:BAKER, BARBARA A (LICSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:BAKER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ELM ST
Mailing Address - Street 2:SUITE #5
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2871
Mailing Address - Country:US
Mailing Address - Phone:978-697-6025
Mailing Address - Fax:
Practice Address - Street 1:5 ELM ST
Practice Address - Street 2:SUITE #5
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2871
Practice Address - Country:US
Practice Address - Phone:978-697-6025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10328281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA591250000OtherMAGELLAN
MAP08062OtherBCBSMA
MA7721558OtherAETNA
MA013344OtherHARVARD PILGRIM
MAP08062OtherBCBSMA