Provider Demographics
NPI:1154466118
Name:BAKER, CONNIE LYN (MSW)
Entity type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:LYN
Last Name:BAKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:CONNIE
Other - Middle Name:LYN
Other - Last Name:BAKER-JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:721 SE REDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-4714
Mailing Address - Country:US
Mailing Address - Phone:816-229-7275
Mailing Address - Fax:
Practice Address - Street 1:8150 WORNALL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-5806
Practice Address - Country:US
Practice Address - Phone:816-508-3500
Practice Address - Fax:816-508-3535
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0048081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical