Provider Demographics
NPI:1952747693
Name:BAKER, ROSE MARIE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ROSE
Middle Name:MARIE
Last Name:BAKER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:BAKER GRAFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:110 HAVERHILL RD
Mailing Address - Street 2:STE 507
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2141
Mailing Address - Country:US
Mailing Address - Phone:603-926-7131
Mailing Address - Fax:
Practice Address - Street 1:110 HAVERHILL RD # A-507
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-2123
Practice Address - Country:US
Practice Address - Phone:603-770-5438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10214201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical