Provider Demographics
NPI:1912310830
Name:BAKER, AURELIA (LCAS, LPC)
Entity type:Individual
Prefix:
First Name:AURELIA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:LCAS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 LYNDHURST AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5104
Mailing Address - Country:US
Mailing Address - Phone:704-446-0271
Mailing Address - Fax:704-348-4057
Practice Address - Street 1:1816 LYNDHURST AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5104
Practice Address - Country:US
Practice Address - Phone:704-446-0271
Practice Address - Fax:704-348-4057
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1699101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)