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NPI Code Detail

MEDICARE: SHELBY BAKER LCADC

MEDICARE: SHELBY BAKER LCADC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor37LC00389900NJ

General Provider Information

NPI Number : 1548107311
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY BAKER LCADC
Provider Business Mailing Address
First Line : 5 GRAYBURN DR
Second Line :
City : MARLTON
State : NJ
Zip : 08053-1921
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 221 RIVER ST STE 9
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-5990
Country : US
Telephone Number : 646-941-7645
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2026
Last Update Date : 04/30/2026

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Directions to “ SHELBY BAKER LCADC” Practice Location

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