Roger Baker
Individual provider Active NPI Mental Health Counselor · Odessa, FL
NPI 1154083418 · NPPES record last updated Oct 13, 2021
Key facts
- NPI
- 1154083418
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 10209 Lake Grove Dr
Odessa, FL 33556-2504 - Phone
- (813) 368-9645
- NPI assigned
- Oct 13, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH7025 | FL | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH7025 | FL | |
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
10209 Lake Grove Dr
Odessa, FL 33556-2504
Mailing address
10209 Lake Grove Dr
Odessa, FL 33556-2504
Phone (813) 368-9645
Other providers in Odessa, FL
- Gonzalo Arboleda
- ASC of Trinity
- Asg Support Services Inc
- Aviezri Healthcare LLC
- Melody Noel Baade
- J David Barr
- Samir Barsoum
- Laura Stacey Bass
- Krishan K. Batra
- Kritti K. Batra
All providers in Odessa, FL · Mental Health Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.