Healthcare Provider Details

I. General information

NPI: 1699538389
Provider Name (Legal Business Name): ALICE BAKER MSRD LMHC LPC LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALICE WILLIAMS

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31211 N 44TH WAY
CAVE CREEK AZ
85331-3701
US

IV. Provider business mailing address

31211 N 44TH WAY
CAVE CREEK AZ
85331-3701
US

V. Phone/Fax

Practice location:
  • Phone: 407-340-8251
  • Fax:
Mailing address:
  • Phone: 407-340-8251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number21906
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number16829
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number4505
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number845440
License Number StateAZ
# 7
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: