Provider Demographics
NPI:1083998397
Name:RAKES, MEGAN LIANE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:LIANE
Last Name:RAKES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 EDGELL RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4874
Mailing Address - Country:US
Mailing Address - Phone:732-500-6131
Mailing Address - Fax:
Practice Address - Street 1:5 EDGELL RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-4874
Practice Address - Country:US
Practice Address - Phone:732-500-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA8936OtherBOARD OF ALLIED MENTAL HEALTH