Provider Demographics
NPI:1629367057
Name:BAXTER, PATRICIA ANN (MA, PCC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:BAXTER
Suffix:
Gender:F
Credentials:MA, PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6881 BEECHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2907
Mailing Address - Country:US
Mailing Address - Phone:513-233-4836
Mailing Address - Fax:513-232-3573
Practice Address - Street 1:6881 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230
Practice Address - Country:US
Practice Address - Phone:513-233-4836
Practice Address - Fax:513-232-3573
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0005132.SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health