Active NPI
Traci Baker, LCSW
- Clinical Social Worker
- Sikeston, MO
National Provider Identifier
1508270752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2012036978
- Practice address
- 903 S Kingshighway St
Sikeston, MO 63801-4415 - Phone
- (573) 472-2139
- NPI assigned
- Jun 16, 2014
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2012036978 | MO | Primary |
Addresses
Primary practice location
903 S Kingshighway St
Sikeston, MO 63801-4415
Mailing address
903 S Kingshighway St
Sikeston, MO 63801-4415
Phone (573) 472-2139
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012036978 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402876800000",
"number": "1508270752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "903 S KINGSHIGHWAY ST",
"city": "SIKESTON",
"state": "MO",
"postal_code": "638014415",
"telephone_number": "573-472-2139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "903 S KINGSHIGHWAY ST",
"city": "SIKESTON",
"state": "MO",
"postal_code": "638014415",
"telephone_number": "573-472-2139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKER",
"first_name": "TRACI",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-16",
"last_updated": "2014-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2012036978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sikeston, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.