Provider Demographics
NPI:1760623995
Name:BAKER, LAURA LEE (MA, LPC, NCC, CPCS)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LEE
Last Name:BAKER
Suffix:
Gender:F
Credentials:MA, LPC, NCC, CPCS
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:LEE
Other - Last Name:BELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPCS
Mailing Address - Street 1:1815 OLD 41 HWY NW STE 110
Mailing Address - Street 2:LEGACY STRATEGY INC.
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-4422
Mailing Address - Country:US
Mailing Address - Phone:678-468-9103
Mailing Address - Fax:
Practice Address - Street 1:1815 OLD 41 HWY NW STE 110
Practice Address - Street 2:LEGACY STRATEGY INC.
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-4422
Practice Address - Country:US
Practice Address - Phone:678-468-9103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005629101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health