KELLY GOSSARD BAKER (NPI# 1871841254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871841254 |
Entity Type | Individual |
Full Name | KELLY GOSSARD BAKER |
Other Name | KELLY R BAKER |
Credential | LMHC |
Practice Address |
6838 E Genesee St Ste E Fayetteville NY 13066-1029 |
Practice Telephone | 3154307150 |
Mailing Telephone | 3154307150 |
Enumeration Date | 2012-08-16 |
Last Update Date | 2020-09-16 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
000882 | NY | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | GROUP MEDICAID | 02994838 | 01 |
NY | GROUP MEDICARE | BA1047 | 01 |
GROUP NPI | 1235184235 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346767506 | Kelly Baker | Social Worker | 520 Superior St., Port Huron, MI 48060 | 2017-08-28 |
1740729508 | Kelly Marie Baker | Registered Nurse | 220 Sandy Brook Rd, North Scituate, RI 02857-2840 | 2017-02-13 |
1922496538 | Kelly Michelle Baker | Social Worker | 2319 Good Hope Ct Se Apt 203, Washington, DC 20020-3683 | 2015-01-05 |
1104258706 | Kelly Baker | Doula | 410 Wells Ln, Versailles, KY 40383-1545 | 2013-08-06 |
1316287352 | Kelly Lind Baker | Doula | 9622 Stockport Cir, Summerville, SC 29485-9006 | 2013-02-28 |
1346585163 | Kelly Elizabeth Baker | Acupuncturist | 11300 Roosevelt Way Ne Ste 100, Seattle, WA 98125-6243 | 2012-12-05 |
1124253596 | Kelly Ann Baker | Physical Therapist | 5100 Bradenton Ave Ste D, Dublin, OH 43017 | 2009-05-28 |
1073775185 | Kelly Baker | Skilled Nursing Facility | 853 Lexington Rd, Harrodsburg, KY 40330-1260 | 2008-06-30 |
1841494085 | Kelly Marie Baker | Counselor | 121 S Madison, Pittsfield, IL 62363 | 2007-06-12 |
1619013398 | Kelly W Baker | Chiropractor | 852 Manzanita Ct Ste 150, Chico, CA 95926-2399 | 2007-01-29 |
Street Address |
6838 E GENESEE ST STE E |
City | FAYETTEVILLE |
State | NY |
Zip Code | 13066-1029 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457819963 | Word Wellness Center, LLC | Psychologist | 6836 E Genesee Street, Suite A, Fayetteville, NY 13066 | 2019-03-05 |
1629529060 | Lorna Boyer Chase | Marriage & Family Therapist | 109 White Heron Circle, Fayetteville, NY 13066 | 2016-10-20 |
1699221432 | Roman Batyuk | Nurse Practitioner | 4100 Medical Center Drive, Fayetteville, NY 13066 | 2016-08-31 |
1427405133 | National Eye Care, Inc | Optometrist | 5160 Kinloch Circle, Fayetteville, NY 13066 | 2016-05-23 |
1013375328 | Kristin Kukenberger | Chiropractor | 7000 E Genesee St Bldg B, Fayetteville, NY 13066 | 2016-02-01 |
1124394671 | Susan Hartman Brenizer | Marriage & Family Therapist | 7000 E Genesee St Lyndon Office Park, Bldg. A, Second Floor (upper Level), Fayetteville, NY 13066 | 2012-03-29 |
1245541432 | Rene L Converse | Occupational Therapist | 7200 E. Genesee Street, Fayetteville, NY 13066 | 2010-06-23 |
1689815805 | Menorah Park Group Residents | Clinic/Center | 12 Jamar Drive, Dewitt, NY 13066 | 2009-03-18 |
1063677458 | John Marcena Glezen | Obstetrics & Gynecology | 1 The Gazebo, Fayetteville, NY 13066 | 2008-07-24 |
1629232418 | Tucker Martin Harris | Otolaryngology | 4000 Medical Center Dr # 117, Fayetteville, NY 13066 | 2008-07-11 |
Find all providers in zip 13066 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619583432 | Don Del-raye Jones | Counselor | 521 Rempstone Ln, Fayetteville, NC 28311-5501 | 2020-09-17 |
1023628278 | Quadiedra Amos | Counselor | 3675 Fallstaff Dr, Fayetteville, NC 28306-9079 | 2020-08-03 |
1699385963 | William Jones | Counselor | 4250 Clinton Rd Ste 102, Fayetteville, NC 28312-8517 | 2020-08-03 |
1952919573 | Bianca Thomas | Counselor | 2713 Lake Club Dr, Fayetteville, NC 28304-5349 | 2020-07-20 |
1962029546 | Deanna Dale Dunn | Counselor | 767 W North St Ste 112, Fayetteville, AR 72701-1865 | 2020-06-30 |
1053937490 | Balance Ground Counseling LLC | Counselor | 240 Lofty Eagle Ln, Fayetteville, GA 30214-3531 | 2020-06-22 |
1659994010 | Martanika Michelle Smith | Counselor | 351 Wagoner Dr Ste 105, Fayetteville, NC 28303-4608 | 2020-05-20 |
1477188985 | Qiana Tamieka Gatling | Counselor | 4417 Briton Cir, Fayetteville, NC 28314-2401 | 2020-03-04 |
1467086496 | The Pair Center for Couples Counseling Pllc | Counselor | 5085 Morganton Road, Suite 300, Fayetteville, NC 28314 | 2020-02-28 |
1194359182 | Meredith Leigh Kimbrough | Counselor | 31 E Center St Ste 210, Fayetteville, AR 72701-5391 | 2020-02-27 |
Find all providers in FAYETTEVILLE |
City | FAYETTEVILLE |
Zip Code | 13066 |
Please comment or provide details below to improve the information on KELLY GOSSARD BAKER.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.