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NPI Code Detail

MEDICARE: SHANNA N BAKER MSW, LCSW

MEDICARE: SHANNA N BAKER MSW, LCSW
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
11041C0700XClinical Social Worker2026012420MO

General Provider Information

NPI Number : 1114778198
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNA N BAKER MSW, LCSW
Provider Business Mailing Address
First Line : 1601 OLD SOUTH RIVER RD
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-4120
Country : US
Telephone Number : 636-224-1210
Fax Number : 636-246-1008
Provider Business Practice Location Address
First Line : 900 E LAHARPE ST
Second Line :
City : KIRKSVILLE
State : MO
Zip : 63501-4520
Country : US
Telephone Number : 660-665-1962
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2024
Last Update Date : 04/08/2026

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