Healthcare Provider Details

I. General information

NPI: 1972870723
Provider Name (Legal Business Name): KARIE A BAKER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. KARIE A DELAURENTIIS

II. Dates (important events)

Enumeration Date: 11/22/2011
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 WESTFALL RD
ROCHESTER NY
14620-4610
US

IV. Provider business mailing address

620 WESTFALL RD
ROCHESTER NY
14620-4610
US

V. Phone/Fax

Practice location:
  • Phone: 585-461-8500
  • Fax: 585-241-2685
Mailing address:
  • Phone: 585-461-8500
  • Fax: 585-241-2685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number019488-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number019488-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: