Healthcare Provider Details

I. General information

NPI: 1104740497
Provider Name (Legal Business Name): JENNIFER BAKER, LMFT-S LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4814 SE ELLSWORTH AVE
LAWTON OK
73501-8337
US

IV. Provider business mailing address

1217 NW SHERIDAN RD # 1003
LAWTON OK
73505-5209
US

V. Phone/Fax

Practice location:
  • Phone: 888-717-5145
  • Fax:
Mailing address:
  • Phone: 888-717-5145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER BAKER
Title or Position: OWNER
Credential: LMFT
Phone: 888-717-5145