Individual
SHUKAIRO MACK BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC, LCSW
Contact information
Practice address
455 LAKESHORE PKWY, ROCK HILL, SC 29730-4205
(803) 909-6363
(803) 909-6390
Mailing address
455 LAKESHORE PKWY, ROCK HILL, SC 29730-4205
(877) 658-8669
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C008389
NC
1041C0700X
Clinical Social Worker
11094
SC
1041C0700X
Clinical Social Worker
C008389
NC
163W00000X
Registered Nurse
268707
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024194469
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
13998789-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
13998789-8900
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
254611
MT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
31253A
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
317733
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5020242
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
890763
NV
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP70007419
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN11044782
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
C-RXN.0102908-C-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659666444
—
NC
01
—
Q554550281
PTAN
SC
05
—
SW1253
—
SC
Enumeration date
06/09/2011
Last updated
05/05/2026
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