Individual provider Active NPI

Mandy Crystal Baker, LMHC

  • Mental Health Counselor
  • North Providence, RI
National Provider Identifier
1922160555
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6157 Issued in MA
Practice address
8 Hillview Drive
North Providence, RI 02904
Phone
(508) 216-0077
Fax
(508) 507-3350
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X MCH00986 RI
Counselor 101Y00000X 6157 MA
Mental Health Counselor 101YM0800X 6157 MA Primary

Addresses

Primary practice location

8 Hillview Drive
North Providence, RI 02904

Mailing address

371 Potnam Pike Ste 230 PMB 1003
Smithfield, RI 02917
Phone (508) 216-0077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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

Enrollment IDStateProvider typePAC IDDetails
I20240129004254 RI Practitioner - Mental Health Counselor 9436502192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

371 Putnam Pike
Suite 230
Smithfield, RI 02917-2445

8 Hillview Dr
North Providence, RI 02904-4617
Phone (508) 942-6614

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MCH00986RIMDCounselor
6157MAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Mind Counseling LLC CurrentSince Jan 3, 2024 Accepting new patients

Locations

371 Putnam Pike
Ste 230
Smithfield, RI 02917
Phone (865) 801-0318

Organizations & group practices 1

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1922160555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 POTNAM PIKE STE 230 PMB 1003",
            "city": "SMITHFIELD",
            "state": "RI",
            "postal_code": "02917",
            "telephone_number": "508-216-0077",
            "fax_number": "508-507-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 HILLVIEW DRIVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "02904",
            "telephone_number": "508-216-0077",
            "fax_number": "508-507-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "MANDY",
        "middle_name": "CRYSTAL",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "RI",
            "license": "MCH00986",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MA",
            "license": "6157",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "6157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Providence, RI

Sources for this page

Verify at the official NPI Registry.