Nicole Rene Baker, LSSP

Key facts

NPI

1477439735

Entity type

Individual (NPI type 1)

Primary specialty

School Psychologist 103TS0200X

License

72647 (TX)

Practice address

121 S Main St
Lumberton, TX 77657-7368

Phone

(409) 454-0366

NPI assigned

Aug 13, 2025

Sex

Female

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

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 13, 2025.

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1477439735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7102 MUSTANG TRL",
            "city": "KOUNTZE",
            "state": "TX",
            "postal_code": "776258374",
            "telephone_number": "409-454-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S MAIN ST",
            "city": "LUMBERTON",
            "state": "TX",
            "postal_code": "776577368",
            "telephone_number": "409-454-0366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Canyon Lake Cir",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "TX",
            "postal_code": "776573701",
            "country_code": "US",
            "telephone_number": "409-454-0366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER",
        "first_name": "NICOLE",
        "middle_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "LSSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "TX",
            "license": "72647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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