Provider Demographics
NPI:1649506601
Name:BAKER, CINDY CAROL BAAS (LPC)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:CAROL BAAS
Last Name:BAKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2089
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-0036
Mailing Address - Country:US
Mailing Address - Phone:678-882-2227
Mailing Address - Fax:770-445-7262
Practice Address - Street 1:110 EVANS MILL DR
Practice Address - Street 2:SUITE 305
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-1622
Practice Address - Country:US
Practice Address - Phone:770-445-6358
Practice Address - Fax:770-445-7262
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005019101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
1245530120OtherNPI # FOR BAKER COUNSELING RESOURCES, LLC