Provider Demographics
NPI:1023117496
Name:BAKER, NORA RALSTON (MSW LCSWC)
Entity type:Individual
Prefix:MRS
First Name:NORA
Middle Name:RALSTON
Last Name:BAKER
Suffix:
Gender:F
Credentials:MSW LCSWC
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:210 GORDON RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:17320-9123
Mailing Address - Country:US
Mailing Address - Phone:223-272-9439
Mailing Address - Fax:717-334-4125
Practice Address - Street 1:210 GORDON RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:PA
Practice Address - Zip Code:17320-9123
Practice Address - Country:US
Practice Address - Phone:223-272-9439
Practice Address - Fax:717-334-4125
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0207101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD082401100Medicaid