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NPI Code Detail

MEDICARE: PETER BAAKO M.S, LPC

MEDICARE: PETER BAAKO M.S, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2101YM0800XMental Health CounselorC.2204430OH

General Provider Information

NPI Number : 1104168053
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER BAAKO M.S, LPC
Provider Business Mailing Address
First Line : 5400 EDALBERT DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45239-7604
Country : US
Telephone Number : 513-741-3100
Fax Number : 513-741-5686
Provider Business Practice Location Address
First Line : 274 SUTTON RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45230-3521
Country : US
Telephone Number : 515-231-5010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2013
Last Update Date : 09/28/2023

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