Provider Demographics
NPI:1972131415
Name:BAKER, PAUL STEVEN (LPC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:STEVEN
Last Name:BAKER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8740 CARLITAS JOY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-3536
Mailing Address - Country:US
Mailing Address - Phone:810-247-1195
Mailing Address - Fax:
Practice Address - Street 1:8740 CARLITAS JOY CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3536
Practice Address - Country:US
Practice Address - Phone:810-247-1195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401005794101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health