MEDICARE: NADIA COLEMESS BAKER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	114714-01	NY
2	1041C0700X	Clinical Social Worker	100014	NY

General Provider Information

NPI Number	:	1518627744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADIA COLEMESS BAKER LCSW

Provider Business Mailing Address
First Line	:	134 N 4TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11249-3296
Country	:	US
Telephone Number	:	716-940-7095
Fax Number	:

Provider Business Practice Location Address
First Line	:	832 OFANTO WAY
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-7760
Country	:	US
Telephone Number	:	716-940-7095
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2021
Last Update Date	:	04/26/2025

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