JACK DAVID BAKER PHD
NPI 1073155453
Psychologist in Arlington, VA

Active since October 17, 2019Opted out of Medicare · through Nov 14, 2026
1530 WILSON BLVD STE 360, ARLINGTON, VA 22209(571) 534-3825 Get Directions Write a Review

NPPES record last updated: March 14, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jack David Baker Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK DAVID BAKER PHD (NPI 1073155453) is an individual psychologist in Arlington, Virginia and active in the NPI registry since October 2019. He has opted out of Medicare through November 14, 2026.

NPPES Registry Identity

NPI1073155453
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameJACK DAVID BAKERCredential: PHD
Location Address1530 WILSON BLVD STE 360Arlington, VA 22209-2466
Mailing Address1530 Wilson Blvd Ste 360Arlington, VA 22209-2466
Sole ProprietorNo
Enumeration DateOctober 17, 2019
Last NPPES UpdateMarch 14, 2024
NPPES CertifiedMarch 14, 2024
NPI 1073155453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1530 WILSON BLVD STE 360, Arlington, VA 22209

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Jack David Baker Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 14, 2022 through November 14, 2026.

Opt-Out Effective DateNovember 14, 2022
Opt-Out In Effect ThroughNovember 14, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Clinical)
1530 WILSON BLVD STE 360
ARLINGTON, VA 22209
Clinic/Center (Mental Health (Including Community Mental Health Center))
1530 WILSON BLVD STE 360
ARLINGTON, VA 22209
Psychologist (Clinical)
1530 WILSON BLVD STE 360
ARLINGTON, VA 22209

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Baker's NPI number?

The NPI number for Jack Baker is 1073155453. It was assigned to this individual provider in the NPPES registry on October 17, 2019.

Where is Jack Baker located?

Jack Baker practices at 1530 Wilson Blvd Ste 360, Arlington, VA 22209. The listed phone number is (571) 534-3825.

What is Jack Baker's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jack Baker enrolled in Medicare?

No. Jack Baker has opted out of Medicare through November 14, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jack Baker was last updated on March 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.