Provider Demographics
NPI:1861014912
Name:BAKER, NICOLE ANGELA (MA, EDS, LPA)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ANGELA
Last Name:BAKER
Suffix:
Gender:F
Credentials:MA, EDS, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 REED ST
Mailing Address - Street 2:SUITE 202, BOX 4
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803
Mailing Address - Country:US
Mailing Address - Phone:865-599-0701
Mailing Address - Fax:
Practice Address - Street 1:25 REED ST STE 202
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2770
Practice Address - Country:US
Practice Address - Phone:865-599-0701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4280103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty