Provider Demographics
NPI:1821516865
Name:BAKER, RACHEL MEG (LSW)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:MEG
Last Name:BAKER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:MEG
Other - Last Name:KENDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12 W BROWNING RD
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-1112
Mailing Address - Country:US
Mailing Address - Phone:732-713-5896
Mailing Address - Fax:
Practice Address - Street 1:1722 S BROADWAY
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08104-1306
Practice Address - Country:US
Practice Address - Phone:732-713-5896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ9005931041S0200X
NJSW134207104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty