Provider Demographics
NPI:1619412665
Name:BAKER, STEPHEN WADE (EDD, NCC, LPC)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:WADE
Last Name:BAKER
Suffix:
Gender:M
Credentials:EDD, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 S FRIENDSWOOD DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-3989
Mailing Address - Country:US
Mailing Address - Phone:844-824-8775
Mailing Address - Fax:281-648-2200
Practice Address - Street 1:11551 FOREST CENTRAL DR STE 202
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3920
Practice Address - Country:US
Practice Address - Phone:844-824-8775
Practice Address - Fax:281-648-2200
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-29
Last Update Date:2025-12-02
Deactivation Date:2025-10-10
Deactivation Code:
Reactivation Date:2025-12-02
Provider Licenses
StateLicense IDTaxonomies
TX84270101YM0800X, 101YP2500X
OK10805101YP2500X
LA9458101YP2500X
MO2015026792101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health