Provider Demographics
NPI:1750997029
Name:BAKER, NANCY SANDERSON (LPC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:SANDERSON
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 1:10560 MAIN ST STE 518
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7173
Mailing Address - Country:US
Mailing Address - Phone:703-334-9299
Mailing Address - Fax:
Practice Address - Street 1:10560 MAIN ST STE 518
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7173
Practice Address - Country:US
Practice Address - Phone:703-349-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional