Provider Demographics
NPI:1568012870
Name:BAKER, SETH SEBASTIAN (LCSW)
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:SEBASTIAN
Last Name:BAKER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 ALMOND TREE LN
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-1742
Mailing Address - Country:US
Mailing Address - Phone:850-497-2265
Mailing Address - Fax:
Practice Address - Street 1:308 ALMOND TREE LN
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-1742
Practice Address - Country:US
Practice Address - Phone:850-497-2265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2022-00931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical