Healthcare Provider Details

I. General information

NPI: 1144773433
Provider Name (Legal Business Name): MARSHA LYNN BAKER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2016
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 6180
APO AE
09604-6180
US

IV. Provider business mailing address

PSC 103 BOX 2092
APO AE
09603-0021
US

V. Phone/Fax

Practice location:
  • Phone: 314-632-5105
  • Fax:
Mailing address:
  • Phone: 941-227-0293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10912
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: