Provider Demographics
NPI:1578809067
Name:BAKER, LAURIE A (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
Last Name:BAKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:A
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2307 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-6107
Mailing Address - Country:US
Mailing Address - Phone:315-223-8889
Mailing Address - Fax:315-223-8890
Practice Address - Street 1:2307 GENESEE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501
Practice Address - Country:US
Practice Address - Phone:315-223-8889
Practice Address - Fax:315-223-8890
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0866671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1215098207Medicaid