Provider Demographics
NPI:1043360092
Name:BAKER, KALE (LSCW)
Entity type:Individual
Prefix:MR
First Name:KALE
Middle Name:
Last Name:BAKER
Suffix:
Gender:M
Credentials:LSCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12550 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 934
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2541
Mailing Address - Country:US
Mailing Address - Phone:305-892-4753
Mailing Address - Fax:305-892-4751
Practice Address - Street 1:12550 BISCAYNE BLVD
Practice Address - Street 2:SUITE 934
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2541
Practice Address - Country:US
Practice Address - Phone:305-892-4753
Practice Address - Fax:305-892-4751
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW53531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical