Healthcare Provider Details

I. General information

NPI: 1184289936
Provider Name (Legal Business Name): MONICA BAKER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2019
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 W ECHETA RD
GILLETTE WY
82716-9121
US

IV. Provider business mailing address

291 W ECHETA RD
GILLETTE WY
82716-9121
US

V. Phone/Fax

Practice location:
  • Phone: 307-299-2180
  • Fax:
Mailing address:
  • Phone: 307-299-2180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8861117
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCW-1771
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: