Provider Demographics
NPI:1710041132
Name:BAKER, WILLIAM T (MSW, ACSW, LICSW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:T
Last Name:BAKER
Suffix:
Gender:M
Credentials:MSW, ACSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2253
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99210-2253
Mailing Address - Country:US
Mailing Address - Phone:509-466-0220
Mailing Address - Fax:509-466-0220
Practice Address - Street 1:505 W SAINT THOMAS MORE WAY
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6026
Practice Address - Country:US
Practice Address - Phone:509-466-0220
Practice Address - Fax:509-466-0220
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000044341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical