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General NPI Number Information
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NPI Number | 1881059616
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Entity Type | Individual
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Provider Name | SHARONA C BAKER LMHC, RMFTI
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Gender | Female
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Dates
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Enumeration Date | 12/21/2015
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 871 W OAKLAND PARK BLVD
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City | WILTON MANORS
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State | FL
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Zip | 33311-1731
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Country | US
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Telephone | 954-567-7141
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Fax | 954-703-2029
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Provider Business Mailing Address
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Address Line | 871 W OAKLAND PARK BLVD
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City | WILTON MANORS
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State | FL
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Zip | 33311-1731
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Country | US
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Telephone | 954-567-7141
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Fax | 954-703-2029
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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 | IMH 14153
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMT 2417
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH16634
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License Number State | FL
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