Provider Demographics
NPI:1588112718
Name:BAKER, PATRICK (LCSW)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
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:PSC 480 BOX 15
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96370-0001
Mailing Address - Country:US
Mailing Address - Phone:315-623-7819
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HEALTH CLINIC PATUXENT RIVER
Practice Address - Street 2:47149 BUSE RD. BUILDING 1370
Practice Address - City:PATUXENT RIVER
Practice Address - State:MD
Practice Address - Zip Code:20670
Practice Address - Country:US
Practice Address - Phone:301-342-1419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD174461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical