Provider Demographics
NPI:1639363229
Name:BAER, SCOTT EDWIN (LCSW)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:EDWIN
Last Name:BAER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1669 WINDHAM WAY, CASI
Mailing Address - Street 2:SUITE B
Mailing Address - City:O'FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269
Mailing Address - Country:US
Mailing Address - Phone:618-622-2579
Mailing Address - Fax:618-624-8506
Practice Address - Street 1:1669 WINDHAM WAY, CASI
Practice Address - Street 2:SUITE B
Practice Address - City:O'FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269
Practice Address - Country:US
Practice Address - Phone:618-622-2579
Practice Address - Fax:618-624-8506
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical