Deborah Ann Baker, PHD
Individual provider Active NPI Clinical Psychologist · Peterson Space Force Base, CO
NPI 1710970751 · NPPES record last updated Mar 4, 2024
Key facts
- NPI
- 1710970751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY002653 (GA)
- Practice address
- 559 Vincent Street
Space Base Delta 1
Peterson Space Force Base, CO 80914 - Phone
- (719) 556-9858
- NPI assigned
- Aug 24, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY002653 | GA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Ona Graham, PC | Past | Accepting new patients | |
| Georgia Department of Human Resources | Past | Accepting new patients | |
| Dr. Ona Graham, PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY002653 | GA | Yes |
Addresses
Primary practice location
559 Vincent Street
Space Base Delta 1
Peterson Space Force Base, CO 80914
Mailing address
205 Splendor View Dr
Branson, MO 65616-7660
Phone (706) 593-5195
Other practice location 1
655 7th St
Warner Robins, GA 31098-2227
Phone (478) 327-8487
Other practice location 2
800 Hospital Drive
Columbia, MO 65212-2227
Phone (573) 814-6000
Other practice location 3
4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098
Phone (573) 596-0035
Other providers in Peterson Space Force Base, CO
All providers in Peterson Space Force Base, CO · Clinical Psychologist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.