Provider Demographics
NPI:1700169224
Name:BAKER, KERI LISA I (COUNSELOR)
Entity Type:Individual
Prefix:MS
First Name:KERI
Middle Name:LISA
Last Name:BAKER
Suffix:I
Gender:F
Credentials:COUNSELOR
Other - Prefix:MS
Other - First Name:KERI
Other - Middle Name:LISA
Other - Last Name:BAKER
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:CAADACLL
Mailing Address - Street 1:1203 AMERICAN GREETING CARD RD
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-4811
Mailing Address - Country:US
Mailing Address - Phone:606-528-7010
Mailing Address - Fax:
Practice Address - Street 1:1203 AMERICAN GREETING CARD RD
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-4811
Practice Address - Country:US
Practice Address - Phone:606-528-7010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator