Provider Demographics
NPI:1952474819
Name:BAKER, MORVEN R (D MIN PCC NCC)
Entity Type:Individual
Prefix:DR
First Name:MORVEN
Middle Name:R
Last Name:BAKER
Suffix:
Gender:F
Credentials:D MIN PCC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 E MAIN ST
Mailing Address - Street 2:BOX 150
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805
Mailing Address - Country:US
Mailing Address - Phone:419-606-9091
Mailing Address - Fax:419-281-0923
Practice Address - Street 1:240 UNION STREET
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805
Practice Address - Country:US
Practice Address - Phone:419-606-9091
Practice Address - Fax:419-281-0923
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2357101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
20341347400OtherBWC OHIO
000000385079OtherANTHEM BL CRSS BL SHIELD
2178904OtherCIGNA
266344OtherCOMPSYCH
1153825OtherCAQH
263925OtherCOMPSYCH
7407148OtherAETNA