Provider Demographics
NPI:1629384706
Name:BAER, DONALD (LPC, LMFT, LPA)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:
Last Name:BAER
Suffix:
Gender:M
Credentials:LPC, LMFT, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 W MAGNOLIA AVE STE 20
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4571
Mailing Address - Country:US
Mailing Address - Phone:817-926-0801
Mailing Address - Fax:817-926-0801
Practice Address - Street 1:909 W MAGNOLIA AVE STE 20
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4571
Practice Address - Country:US
Practice Address - Phone:817-926-0801
Practice Address - Fax:817-926-0801
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10028101YP2500X
TX10681106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional