Healthcare Provider Details

I. General information

NPI: 1902856057
Provider Name (Legal Business Name): BILL J BAKER LPC LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 RIVERCHASE RIDGE SUITE 100
BIRMINGHAM AL
35244
US

IV. Provider business mailing address

2 RIVERCHASE RIDGE SUITE 100
BIRMINGHAM AL
35244
US

V. Phone/Fax

Practice location:
  • Phone: 205-444-0420
  • Fax: 205-403-0747
Mailing address:
  • Phone: 205-444-0420
  • Fax: 205-403-0747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number558
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number039
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: