MEDICARE: MS. CAROL LEE BAKER 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
1	1041C0700X	Clinical Social Worker	SW798	FL

General Provider Information

NPI Number	:	1275680548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROL LEE BAKER LCSW

Provider Business Mailing Address
First Line	:	6937 RIVERGATE AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33637-0908
Country	:	US
Telephone Number	:	813-631-0580
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 E FLETCHER AVE
Second Line	:	129
City	:	TAMPA
State	:	FL
Zip	:	33613-4708
Country	:	US
Telephone Number	:	813-767-6357
Fax Number	:	813-978-0475

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	01/11/2026

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