Provider Demographics
NPI:1396871133
Name:BAKER, ELLEN K (PHD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:K
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3672 WINFIELD LN NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2370
Mailing Address - Country:US
Mailing Address - Phone:202-333-1479
Mailing Address - Fax:202-333-6095
Practice Address - Street 1:3 WASHINGTON CIR NW
Practice Address - Street 2:SUITE 206
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2356
Practice Address - Country:US
Practice Address - Phone:202-429-9829
Practice Address - Fax:202-333-6095
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1258103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical