Stacey M Baker

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

247021 Issued in KY

Practice address

1761 Dixdale Ave
Louisville, KY 40210-2217

Phone

(502) 387-7198

NPI assigned

Mar 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• STL Behavioral Health Individual & Family Services

  • Mental Health Counselor
  • Louisville, KY
  • NPI 1750022265
  NPD Authorized official

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

{
    "created_epoch": "1553299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1871053967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16851",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402560851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 DIXDALE AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402102217",
            "telephone_number": "502-387-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "STACEY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-23",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "247021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YP2500X",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "staybaker1968@yahoo.com",
            "affiliation": "N",
            "address_1": "1761 Dixdale Ave",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402102217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pamela Gay Baker
• Richard Wayne Baker, MD
• Samantha Baker, BCBA
• Samantha D Baker, PHARMD
• Sarah L Baker, LCSW
• Steven Baker, LDO
• Valeciea C Baker, LPCA
• William Anthony Baker, CSFA
• William T Baker, MD
• Omar Bakhaty, MD

• Mental Health Counselor in Louisville, KY
• Providers in Louisville, KY by specialty
• Mental Health Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.