Provider Demographics
NPI:1386974699
Name:BAKER, KAREN L (LCMFT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:BAKER
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 319
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:KS
Mailing Address - Zip Code:66434-0319
Mailing Address - Country:US
Mailing Address - Phone:785-742-7113
Mailing Address - Fax:785-742-3085
Practice Address - Street 1:909 S 2ND ST
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434-2774
Practice Address - Country:US
Practice Address - Phone:785-742-7113
Practice Address - Fax:785-742-3085
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK915106H00000X
KS793106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS595Other193200000X MULTISPECIALTY GROUP 106H00000X MARRIAGE & FAMILY THERAPIST
OK915Other193200000X MULTISPECIALTY GROUP 10600000X MARRIAGE & FAMILY THERAPIST