Provider Demographics
NPI:1962891929
Name:BAKER MCWILLIAMS REALTY INC.
Entity type:Organization
Organization Name:BAKER MCWILLIAMS REALTY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, MHSP
Authorized Official - Phone:615-414-2997
Mailing Address - Street 1:844 CURTIS DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-1302
Mailing Address - Country:US
Mailing Address - Phone:615-414-2997
Mailing Address - Fax:
Practice Address - Street 1:3918 DICKERSON PIKE
Practice Address - Street 2:STE. 108
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-1328
Practice Address - Country:US
Practice Address - Phone:615-414-2997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2839101YM0800X, 101YP2500X, 101YS0200X, 102X00000X, 103TE1100X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No102X00000XBehavioral Health & Social Service ProvidersPoetry TherapistGroup - Multi-Specialty
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & SportsGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN101YM0800XMedicaid