Individual provider Active NPI

Christine Baker, PH.D., LCSW-C, LCADC

  • Counseling Psychologist
  • Waldorf, MD
National Provider Identifier
1861482796
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
09859 Issued in MD
Practice address
3195 Old Washington Rd
Waldorf, MD 20602-3201
Phone
(301) 705-7257
Fax
(301) 705-7257
NPI assigned
Oct 23, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 09859 MD Primary

Addresses

Primary practice location

3195 Old Washington Rd
Waldorf, MD 20602-3201

Mailing address

3195 Old Washington Rd
Waldorf, MD 20602-3201
Phone (301) 705-7257

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
09859MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Valley Medical System, Inc. Past Accepting new patients
Shenandoah Valley Medical System, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1130025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1861482796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3195 OLD WASHINGTON RD",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023201",
            "telephone_number": "301-705-7257",
            "fax_number": "301-705-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3195 OLD WASHINGTON RD",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023201",
            "telephone_number": "301-705-7257",
            "fax_number": "301-705-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCSW-C, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-23",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MD",
            "license": "09859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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.