Provider Demographics
NPI:1760255392
Name:BAER, ANDREW (LPC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:BAER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SOROTZKIN ST
Mailing Address - Street 2:
Mailing Address - City:JERUSALEM
Mailing Address - State:JERUSALEM
Mailing Address - Zip Code:9446512
Mailing Address - Country:IL
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35 SOROTZKIN ST
Practice Address - Street 2:
Practice Address - City:JERUSALEM
Practice Address - State:JERUSALEM
Practice Address - Zip Code:9446512
Practice Address - Country:IL
Practice Address - Phone:732-414-8711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID9639101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional