Provider Demographics
NPI:1750137881
Name:BAKER STREET MIND HEALTH
Entity type:Organization
Organization Name:BAKER STREET MIND HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FARBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-381-6136
Mailing Address - Street 1:851 FRANKLIN LAKE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2267
Mailing Address - Country:US
Mailing Address - Phone:201-381-6136
Mailing Address - Fax:
Practice Address - Street 1:851 FRANKLIN LAKE RD STE 204
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-2267
Practice Address - Country:US
Practice Address - Phone:201-381-6136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty