Provider Demographics
NPI:1114535689
Name:BAKER, CANDICE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:MARIE
Last Name:BAKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:MARIE
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:418 WHISPER LN
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-3232
Mailing Address - Country:US
Mailing Address - Phone:816-535-7800
Mailing Address - Fax:
Practice Address - Street 1:225 SW NOEL ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2241
Practice Address - Country:US
Practice Address - Phone:816-535-7780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health