Provider Demographics
NPI:1700573045
Name:BAKER, STEVEN LAVELLE (APSW)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:LAVELLE
Last Name:BAKER
Suffix:
Gender:M
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 PLEASANT VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:WI
Mailing Address - Zip Code:54155-8622
Mailing Address - Country:US
Mailing Address - Phone:920-784-9276
Mailing Address - Fax:
Practice Address - Street 1:1238 PLEASANT VALLEY DR
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:WI
Practice Address - Zip Code:54155-8622
Practice Address - Country:US
Practice Address - Phone:920-784-9276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI132774-1211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical