Provider Demographics
NPI:1760623995
Name:BAKER, LAURA LEE (MA, LPC, NCC,)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LEE
Last Name:BAKER
Suffix:
Gender:F
Credentials:MA, LPC, NCC,
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:LEE
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA,LPC,NCC
Mailing Address - Street 1:3459 ACWORTH DUE WEST RD NW STE 206
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-5821
Mailing Address - Country:US
Mailing Address - Phone:770-892-6287
Mailing Address - Fax:770-847-8568
Practice Address - Street 1:EXHALE COUNSELING
Practice Address - Street 2:3459 ACWORTH DUE WEST ROAD SUITE 206
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101
Practice Address - Country:US
Practice Address - Phone:770-892-6287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005629101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health