Provider Demographics
NPI:1689701369
Name:BAKER, AMY (MED, LMHC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 LIBERTY ST STE 402
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-1109
Mailing Address - Country:US
Mailing Address - Phone:413-391-7815
Mailing Address - Fax:413-310-3378
Practice Address - Street 1:125 LIBERTY ST STE 402
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1109
Practice Address - Country:US
Practice Address - Phone:413-391-7815
Practice Address - Fax:413-310-3378
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9888101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health