Active NPI
Jacquelyn B Baker, LMHC
- Counselor
- Renton, WA
National Provider Identifier
1215452990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LH61344290
- Practice address
- 340 Morris Ave S
Renton, WA 98057-2521 - Phone
- (206) 717-5915
- NPI assigned
- Aug 3, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LH61344290 | WA | Primary |
Addresses
Primary practice location
340 Morris Ave S
Renton, WA 98057-2521
Mailing address
22027 6TH Ave S Apt 307
Des Moines, WA 98198-6268
Phone (412) 728-3890
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 22, 2024 through Apr 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH61344290 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683244800000",
"number": "1215452990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22027 6TH AVE S APT 307",
"city": "DES MOINES",
"state": "WA",
"postal_code": "981986268",
"telephone_number": "412-728-3890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 MORRIS AVE S",
"city": "RENTON",
"state": "WA",
"postal_code": "980572521",
"telephone_number": "206-717-5915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKER",
"first_name": "JACQUELYN",
"middle_name": "B",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-03",
"last_updated": "2023-05-05",
"certification_date": "2023-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "LH61344290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.