Provider Demographics
NPI:1114288404
Name:FLACHS, SHELLY ARLENE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:ARLENE
Last Name:FLACHS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-6630
Mailing Address - Country:US
Mailing Address - Phone:217-430-8933
Mailing Address - Fax:
Practice Address - Street 1:1728 ADAMS ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-6630
Practice Address - Country:US
Practice Address - Phone:217-430-8933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-03
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20150111351041C0700X
IL1490170531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical