Provider Demographics
NPI:1700303849
Name:BAKER, MADELINE (MSW, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:MADELINE
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 E FRANKLIN ST STE 900B
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-5869
Mailing Address - Country:US
Mailing Address - Phone:919-270-7739
Mailing Address - Fax:
Practice Address - Street 1:1829 E FRANKLIN ST STE 900B
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5869
Practice Address - Country:US
Practice Address - Phone:919-270-7739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
NCC0123181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No172V00000XOther Service ProvidersCommunity Health Worker