Healthcare Provider Details

I. General information

NPI: 1164412821
Provider Name (Legal Business Name): GAIL V BAKER MS , LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 E BROADWAY BLVD
SEDALIA MO
65301-5800
US

IV. Provider business mailing address

305 W 7TH ST
KNOB NOSTER MO
65336-1173
US

V. Phone/Fax

Practice location:
  • Phone: 660-826-2380
  • Fax: 660-826-6737
Mailing address:
  • Phone: 660-826-2380
  • Fax: 660-827-6277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number002463
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: