Provider Demographics
NPI:1699538389
Name:BAKER, ALICE (MSRD LMHC LPC LDN)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MSRD LMHC LPC LDN
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31211 N 44TH WAY
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-3701
Mailing Address - Country:US
Mailing Address - Phone:407-340-8251
Mailing Address - Fax:
Practice Address - Street 1:31211 N 44TH WAY
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-3701
Practice Address - Country:US
Practice Address - Phone:407-340-8251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4505133V00000X
AZ845440133V00000X
AZ101YM0800X
FL101YM0800X, 133V00000X
AZ21906101YM0800X
FL16829101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health