Provider Demographics
NPI:1851845143
Name:BAKER, RHONDA RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:RENEE
Last Name:BAKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4336 PINE TREE CT
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-8590
Mailing Address - Country:US
Mailing Address - Phone:919-432-7132
Mailing Address - Fax:
Practice Address - Street 1:1503 WAYNE MEMORIAL DR STE E
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2203
Practice Address - Country:US
Practice Address - Phone:919-587-0001
Practice Address - Fax:919-587-0007
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0147491041C0700X
NCP0103101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical