MEDICARE: THOMAS P. BAKER L.C.S.W.

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	0904003363	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881629038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS P. BAKER L.C.S.W.

Provider Business Mailing Address
First Line	:	101 N LYNNHAVEN RD
Second Line	:	STE 103
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7523
Country	:	US
Telephone Number	:	757-486-6955
Fax Number	:	757-486-3258

Provider Business Practice Location Address
First Line	:	101 N LYNNHAVEN RD
Second Line	:	STE 103
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7523
Country	:	US
Telephone Number	:	757-437-0008
Fax Number	:	757-437-0019

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	05/28/2016

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Directions to “ THOMAS P. BAKER L.C.S.W.” Practice Location

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