Provider Demographics
NPI:1699350033
Name:BAKER, ERICA ELISA (LPC)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:ELISA
Last Name:BAKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BRIDGE ST STE C
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-4067
Mailing Address - Country:US
Mailing Address - Phone:757-768-6314
Mailing Address - Fax:
Practice Address - Street 1:100 BRIDGE ST STE C
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-4067
Practice Address - Country:US
Practice Address - Phone:757-768-6314
Practice Address - Fax:757-257-6388
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-17
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010077101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional