person
Kelly Gossard Baker, LMHC
Mental Health Counselor in Fayetteville, New York
NPI 1871841254

Kelly Gossard Baker is a Mental Health Counselor based in Fayetteville, NY and is specialized in Mental Health. Kelly Gossard Baker practices in Fayetteville, NY and has the professional credentials of LMHC. The NPI Number for Kelly Gossard Baker is 1871841254 and holds a License No. 000882 (New York).

The current practice location address for Kelly Gossard Baker is 6838 E Genesee St Ste E, Fayetteville, NY and can be reached out via phone at 315-430-7150.

Location: 6838 E Genesee St Ste E, Fayetteville, NY, 13066-1029
person
Provider Profile Details
NPI Number
1871841254
Provider Name
Kelly Gossard Baker
Credential
LMHC
Provider Entity Type
Individual
Gender
Female
Address
6838 E Genesee St Ste E, Fayetteville, NY, 13066-1029
Phone Number
315-430-7150
Fax Number
Provider Enumeration Date
08/16/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
BA1047 01 NY GROUP MEDICARE
1235184235 01 GROUP NPI
02994838 01 NY GROUP MEDICAID
institution
Provider Business Practice Location Address Details
Address
6838 E Genesee St Ste E
City
State
Zip
13066-1029
Phone Number
315-430-7150
Fax Number
person
Provider Business Mailing Address Details
Address
6838 E Genesee St Ste E
City
State
Zip
13066-1029
Phone Number
315-430-7150
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
000882 (New York)
Definition
Definition to come...
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