Healthcare Provider Details

I. General information

NPI: 1386841856
Provider Name (Legal Business Name): JAMIE LYNN BAKER MA, MRC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 03/30/2023
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 ALDRIN RD
PLYMOUTH MA
02360-4827
US

IV. Provider business mailing address

1821 AVALON WAY
PLYMOUTH MA
02360-8804
US

V. Phone/Fax

Practice location:
  • Phone: 508-830-0000
  • Fax:
Mailing address:
  • Phone: 508-648-9232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number434776
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: