Ashley B. Baker, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY003511 Issued in GA

Practice address

101 Colony Park Dr
Ste 300
Cumming, GA 30041

Phone

(678) 679-7118

Fax

(678) 679-7112

NPI assigned

Oct 26, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 25, 2019 through Jan 25, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pavilion Psychological Services LLC

  • Psychologist
  • Cumming, GA
  • NPI 1720441454
  NPD (past) Authorized official

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1255617841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 4551",
            "address_2": "PAULION PSYCHOLOGICAL SERVICES",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "30024",
            "telephone_number": "678-679-7118",
            "fax_number": "678-679-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 COLONY PARK DR",
            "address_2": "STE 300",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "678-679-7118",
            "fax_number": "678-679-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "ASHLEY",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-26",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PS-P000218",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03116200A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Felicity Dwamena Baidoo
• Jaymie Bailey, PA
• Shonda Shanel Bailey, AUD
• David Andrew Bak, D.C.
• Allyson Cole Baker, NP
• Jacqueline R Baker, PA
• Katherine S Baker
• Mackenzie Baker
• Shirley Bakker, FNP
• Balance Achieved LLC

• Clinical Psychologist in Cumming, GA
• Providers in Cumming, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.