Camden L Baucke

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6361007949 Issued in MI

Practice address

3249 Broad St Ste 1
Dexter, MI 48130-1018

Phone

(734) 219-3907

Fax

(734) 418-9110

NPI assigned

Jun 12, 2018

Last updated

Jan 22, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michigan Center for Adult Psychotherapy

  dba Great Lakes Mental Health

  • Clinical Psychologist
  • Dexter, MI
  • NPI 1760066310
  NPD (past)

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1366935603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3249 BROAD ST STE 1",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481301018",
            "telephone_number": "734-219-3907",
            "fax_number": "734-418-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 BROAD ST STE 1",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481301018",
            "telephone_number": "734-219-3907",
            "fax_number": "734-418-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUCKE",
        "first_name": "CAMDEN",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-12",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361007949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• B & G Wellness Inc
• Juliet Webb Ballard
• Robert Ray Baltierra
• Barbara M. Wehr, DDS, PC
• Iris Bashan, PT
• Katherine Begeman
• Aleksandr Belakovskiy, M.D.
• Thomas Lee Bennett
• Bep Medical Group PLLC
• Ennis Berker, PH.D.

• Psychologist in Dexter, MI
• Providers in Dexter, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; 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.