Provider Demographics
NPI:1336358894
Name:BAKER, ELIZABETH A (LP,LMFT)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:A
Last Name:BAKER
Suffix:
Gender:F
Credentials:LP,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 W 102ND ST
Mailing Address - Street 2:STE. 15
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4900
Mailing Address - Country:US
Mailing Address - Phone:212-932-8795
Mailing Address - Fax:
Practice Address - Street 1:240 W 102ND ST
Practice Address - Street 2:STE. 15
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4900
Practice Address - Country:US
Practice Address - Phone:212-932-8795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000639-1102L00000X
NY000421-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist