Gary Lee Baker, LISW
Social Worker, Clinical in Mentor, OH. Individual provider (NPI-1).
NPI number1164905709
StatusActive
Last updated in NPPESOct 15, 2021
Details
- NPI
- 1164905709
- Entity type
- Individual (NPI-1)
- Name
- Gary Lee Baker
- Credential
- LISW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 10, 2018
- Certification date
- Oct 15, 2021
- Last updated
- Oct 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | I.2002236-SUPV | OH | Yes |
| 101YP2500X | Counselor, Professional | 0701003834 | VA |
Practice location
7232 Justin WayMentor, OH 44060-4881
Phone 440-578-8200
Mailing address
7232 Justin WayMentor, OH 44060-4881
Phone 440-578-8200
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