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General NPI Number Information
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NPI Number | 1265074348
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Entity Type | Individual
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Provider Name | MELINDA LEEANN BAKER LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/10/2019
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Last Update Date | 01/11/2023
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Provider Practice Location Address
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Address Line | 1000 N 9TH ST STE 24
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-3161
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Country | US
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Telephone | 970-712-1492
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Fax |
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Provider Business Mailing Address
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Address Line | 710 IVY PL
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City | GRAND JUNCTION
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State | CO
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Zip | 81506-8341
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Country | US
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Telephone | 970-712-1492
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LSW.0009922716
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CSW0992882
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License Number State | CO
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