MEDICARE: DR. CHRISTINE BAKER PH.D., LCSW-C, 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
1	103TC1900X	Counseling Psychologist	09859	MD

General Provider Information

NPI Number	:	1861482796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE BAKER PH.D., LCSW-C, LCADC

Provider Business Mailing Address
First Line	:	3195 OLD WASHINGTON RD
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-3201
Country	:	US
Telephone Number	:	301-705-7257
Fax Number	:	301-705-7257

Provider Business Practice Location Address
First Line	:	3195 OLD WASHINGTON RD
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-3201
Country	:	US
Telephone Number	:	301-705-7257
Fax Number	:	301-705-7257

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

Provider Enumeration Date	:	10/23/2005
Last Update Date	:	06/16/2010

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