Provider Demographics
NPI:1366126757
Name:BAKER, AMY CHANCE (LCSWA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:CHANCE
Last Name:BAKER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:CHANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWA
Mailing Address - Street 1:2830 CRESTSCENE TRL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-6500
Mailing Address - Country:US
Mailing Address - Phone:601-325-1560
Mailing Address - Fax:
Practice Address - Street 1:3725 NATIONAL DR STE 220
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4879
Practice Address - Country:US
Practice Address - Phone:601-325-1560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical