Provider Demographics
NPI:1598706566
Name:BAKER, HARDY EUGENE II (MS, LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:HARDY
Middle Name:EUGENE
Last Name:BAKER
Suffix:II
Gender:M
Credentials:MS, LPC, NCC
Other - Prefix:MR
Other - First Name:RUSS
Other - Middle Name:
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LPC, NCC
Mailing Address - Street 1:316 DENNIS STONER RD
Mailing Address - Street 2:
Mailing Address - City:MACKS CREEK
Mailing Address - State:MO
Mailing Address - Zip Code:65786-7135
Mailing Address - Country:US
Mailing Address - Phone:573-363-5515
Mailing Address - Fax:573-363-5669
Practice Address - Street 1:316 DENNIS STONER RD
Practice Address - Street 2:
Practice Address - City:MACKS CREEK
Practice Address - State:MO
Practice Address - Zip Code:65786-7135
Practice Address - Country:US
Practice Address - Phone:573-363-5515
Practice Address - Fax:573-363-5669
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012011216101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional