Provider Demographics
NPI:1609105006
Name:BAKER, SHERRI
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 W 65TH ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6220 BLUE RIDGE CUTOFF
Practice Address - Street 2:SUITE 312
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-3700
Practice Address - Country:US
Practice Address - Phone:918-606-8725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7266104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker