Healthcare Provider Details

I. General information

NPI: 1770330557
Provider Name (Legal Business Name): HEATHER BAKER COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 N WATER ST # C5
KENT OH
44240-2462
US

IV. Provider business mailing address

4941 ROOTSTOWN RD
RAVENNA OH
44266-7826
US

V. Phone/Fax

Practice location:
  • Phone: 440-225-3066
  • Fax:
Mailing address:
  • Phone: 440-225-3066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: HEATHER BAKER
Title or Position: OWNER/THERAPIST
Credential: LPCC-S
Phone: 440-225-3066