Provider Demographics
NPI:1053372391
Name:BAKER, ROBIN RONALD (LISW)
Entity type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:RONALD
Last Name:BAKER
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7114 W JEFFERSON AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80235-2373
Mailing Address - Country:US
Mailing Address - Phone:877-349-3416
Mailing Address - Fax:888-965-4615
Practice Address - Street 1:7114 W JEFFERSON AVE STE 306
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2373
Practice Address - Country:US
Practice Address - Phone:877-349-3416
Practice Address - Fax:888-965-4615
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099232061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0443291Medicaid
IAP59913Medicare UPIN
IAI13106Medicare ID - Type Unspecified