Laiel Inez Baker-Dekrey, PHD, LP
Individual provider Active NPI Clinical Psychologist · Victoria, MN
NPI 1972826501 · NPPES record last updated Apr 8, 2019
Key facts
- NPI
- 1972826501
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- MN5230 (MN)
- Practice address
- 1772 Stieger Lake LN Ste 220
Victoria, MN 55386-7723 - Phone
- (952) 443-4600
- Fax
- (952) 443-4604
- NPI assigned
- Mar 10, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100609000993 | MN | Practitioner - Clinical Psychologist | 7517097017 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MN5230 | MN | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | MN5230 | MN | Yes |
Addresses
Primary practice location
1772 Stieger Lake LN Ste 220
Victoria, MN 55386-7723
Mailing address
PO Box 51
Victoria, MN 55386-0051
Phone (952) 443-4600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 680002891 | Medicaid | MN |
Other providers in Victoria, MN
- Grace Katherine Anderson
- Rachel D Anderson
- Auburn Lake Academy Corporation
- Augustana Emerald Care LLC
- Haley Elizabeth Backdahl
- Kristine Marie Beer
- Susan Anderson Berger
- Jillyne Bobrowsky
- Nathanyl Bryan Broders
- Shelly Renee Brooks
All providers in Victoria, MN · Clinical Psychologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2019. 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.