Provider Demographics
NPI:1932746476
Name:BAKER, AVERI M (LPC)
Entity Type:Individual
Prefix:
First Name:AVERI
Middle Name:M
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 1:59 ROCK RD FL 1
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-1568
Mailing Address - Country:US
Mailing Address - Phone:862-588-6624
Mailing Address - Fax:847-859-5885
Practice Address - Street 1:231 CLARKSVILLE RD STE 4A
Practice Address - Street 2:
Practice Address - City:PRINCETON JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08550-5300
Practice Address - Country:US
Practice Address - Phone:862-588-6624
Practice Address - Fax:847-859-5885
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00499100101YM0800X
NJ37PC00934500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health