Keegan Baker, LCSW, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

085486 Issued in NY

Legal business name

KEEGAN BAKER, LCSW, PLLC

Practice address

267 E Main St
Smithtown, NY 11787-2874

Phone

(631) 833-5677

NPI assigned

Jul 14, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Raine Keegan Baker, LCSW

Title

Clinical Social Worker

Phone

(631) 833-5677

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499990400000",
    "number": "1083136683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SETALCOTT PL",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117331315",
            "telephone_number": "631-833-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 E MAIN ST",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872874",
            "telephone_number": "631-833-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEEGAN BAKER, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-14",
        "last_updated": "2017-07-14",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "RAINE",
        "authorized_official_middle_name": "KEEGAN",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "631-833-5677",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467727412",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Parviz Kazemi
• Theresa A Keane, LCSW-R
• Kear Mental Health Counseling PLLC
• Lawrence Keating
• Peter A Kechejian, MD.
• Oisin Vincent Keenan
• Amanda Kelly, M.S.
• Carder Kelly, PT
• Dorothy Jane Kelly, LCSW
• John Peter Kelly, PH.D.

• Clinical Social Worker in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.