| Keegan Baker, Lcsw, Pllc | |
|
267 E Main St Smithtown NY 11787-2874 | |
| (631) 833-5677 | |
| Not Available |
| Full Name | Keegan Baker, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 267 E Main St, Smithtown, New York |
| Authorized Official Name and Position | Raine Keegan Baker (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6318335677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keegan Baker, Lcsw, Pllc 3 Setalcott Pl Setauket NY 11733-1315 Ph: (631) 833-5677 | Keegan Baker, Lcsw, Pllc 267 E Main St Smithtown NY 11787-2874 Ph: (631) 833-5677 |
| NPI Number | 1083136683 |
|---|---|
| Provider Enumeration Date | 07/14/2017 |
| Last Update Date | 07/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083136683 | NPI | - | NPPES |
| 1467727412 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 085486 (New York) | Primary |
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