Provider Demographics
NPI:1720415839
Name:BAKER, BARBARA A (LPCC, CADCI)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:BAKER
Suffix:
Gender:F
Credentials:LPCC, CADCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 CENTENNIAL BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-3320
Mailing Address - Country:US
Mailing Address - Phone:541-818-0009
Mailing Address - Fax:
Practice Address - Street 1:1705 CENTENNIAL BLVD STE 2
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-3320
Practice Address - Country:US
Practice Address - Phone:541-818-0009
Practice Address - Fax:541-780-6967
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-04-02101YA0400X
ORC3755101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional