Provider Demographics
NPI:1548413974
Name:OAKES, SHELLY (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:
Last Name:OAKES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:SHELLY
Other - Middle Name:
Other - Last Name:OAKES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:PO BOX 850576
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02185-0576
Mailing Address - Country:US
Mailing Address - Phone:617-733-4777
Mailing Address - Fax:855-433-1835
Practice Address - Street 1:51 THAYER RD
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4323
Practice Address - Country:US
Practice Address - Phone:617-733-4777
Practice Address - Fax:855-433-1835
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA116026172V00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No172V00000XOther Service ProvidersCommunity Health Worker