Provider Demographics
NPI:1285977561
Name:BAKER, LORI JEAN (MS-LMFT)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:JEAN
Last Name:BAKER
Suffix:
Gender:F
Credentials:MS-LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-3102
Mailing Address - Country:US
Mailing Address - Phone:580-649-2087
Mailing Address - Fax:
Practice Address - Street 1:2 SE LEE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-2409
Practice Address - Country:US
Practice Address - Phone:580-355-0072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1211101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health