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KENNISE J BAKER LMSW
NPI 1972205425
Counselor - Mental Health in Herndon, VA

Active since March 20, 2023PECOS EnrolledAccepts Medicare Assignment
2343 DULLES STATION BLVD APT B04, HERNDON, VA 20171(571) 241-9834 Get Directions Write a Review

NPPES record last updated: March 23, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Kennise J Baker Lmsw NPPES

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

KENNISE J BAKER LMSW (NPI 1972205425) is an individual mental health provider in Herndon, Virginia, licensed in Virginia (0903003470) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1972205425
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKENNISE J BAKERCredential: LMSW
Location Address2343 DULLES STATION BLVD APT B04Herndon, VA 20171-6397
Mailing Address11415 Isaac Newton Sq SReston, VA 20190-5005
Phone(571) 241-9834
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMarch 20, 2023
Last NPPES UpdateMarch 23, 2023
NPPES CertifiedMarch 23, 2023
✔ NPI 1972205425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in VA · 0903003470
2343 DULLES STATION BLVD APT B04, Herndon, VA 20171
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kennise J Baker Lmsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608210794
PECOS Enrollment IDI20240216001278
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions

What is Kennise Baker's NPI number?

The NPI number assigned to this healthcare provider is 1972205425, enumerated as an "individual" on March 20, 2023.

Where is the provider located?

The provider is located at 2343 DULLES STATION BLVD APT B04 HERNDON, VA 20171 and the phone number is (571) 241-9834.

What is the provider's specialty?

Counselor with taxonomy code 101YM0800X and a focus in Mental Health.