Provider Demographics
NPI:1720200694
Name:BAKER, LAURA PORTER (MSW LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:PORTER
Last Name:BAKER
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 FARMINGTON AVE
Mailing Address - Street 2:#205
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2667
Mailing Address - Country:US
Mailing Address - Phone:860-899-6394
Mailing Address - Fax:
Practice Address - Street 1:1007 FARMINGTON AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2133
Practice Address - Country:US
Practice Address - Phone:860-899-6394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0044361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical