Provider Demographics
NPI:1356415905
Name:BAKER, PATRICIA ERIN (LISW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ERIN
Last Name:BAKER
Suffix:
Gender:F
Credentials:LISW, LCSW
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ERIN
Other - Last Name:TINGLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW, LCSW
Mailing Address - Street 1:4000 FORT CAMPBELL BLVD STE G4
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-4967
Mailing Address - Country:US
Mailing Address - Phone:270-885-2106
Mailing Address - Fax:
Practice Address - Street 1:4000 FORT CAMPBELL BLVD STE G4
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-4967
Practice Address - Country:US
Practice Address - Phone:270-885-2106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI10173104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker