Provider Demographics
NPI:1205618881
Name:BAKER, SUMMER (MAC)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 6TH INFANTRY RD
Mailing Address - Street 2:
Mailing Address - City:FORT LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66027-1146
Mailing Address - Country:US
Mailing Address - Phone:907-351-6458
Mailing Address - Fax:
Practice Address - Street 1:7200 E HAMPDEN AVE STE 300
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-3021
Practice Address - Country:US
Practice Address - Phone:855-222-1610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)