Stephen Wade Baker, LPC, LCPC, LMHC, CPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C11112 Issued in OR

Practice address

619 E Gray Friar
Marthasville, MO 63357-1503

Phone

(314) 224-9349

NPI assigned

Dec 29, 2016

Reactivated

Dec 2, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Centerstone of Illinois, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Frankfort, IL
  • NPI 1053455667
  Medicare reassignment

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

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1619412665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962210",
            "telephone_number": "618-326-2772",
            "fax_number": "618-937-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 E GRAY FRIAR",
            "city": "MARTHASVILLE",
            "state": "MO",
            "postal_code": "633571503",
            "telephone_number": "314-224-9349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2615 Edwards St",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620023915",
            "country_code": "US",
            "telephone_number": "618-462-2331",
            "fax_number": "618-462-2504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER",
        "first_name": "STEPHEN",
        "middle_name": "WADE",
        "name_prefix": "Mr.",
        "credential": "LPC, LCPC, LMHC, CPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-29",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "deactivation_date": "2025-10-10",
        "reactivation_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IN",
            "license": "39005428A",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2015026792",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "10805",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "9458",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "84270",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CP6342-R",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.017657",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C11112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Thomas Balistrieri, L.P.C.
• Meghan R Cosgrove, RN
• Dobsch Chiropractic and Family Wellness, LLC
• Samantha L Dobsch, DC
• Robin Mackenzie Graumenz, RN, BSN, IBCLC

• Professional Counselor in Marthasville, MO
• Providers in Marthasville, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.