Provider Demographics
NPI:1881059616
Name:BAKER, SHARONA C (LMHC, RMFTI)
Entity type:Individual
Prefix:MS
First Name:SHARONA
Middle Name:C
Last Name:BAKER
Suffix:
Gender:F
Credentials:LMHC, RMFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1731
Mailing Address - Country:US
Mailing Address - Phone:954-567-7141
Mailing Address - Fax:954-703-2029
Practice Address - Street 1:871 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33311-1731
Practice Address - Country:US
Practice Address - Phone:954-567-7141
Practice Address - Fax:954-703-2029
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 14153101YM0800X
FLIMT 2417106H00000X
FLMH16634101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist