Provider Demographics
NPI:1992867733
Name:OAKES, JESSICA ROBIN (LCSW, LADC, CCS)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ROBIN
Last Name:OAKES
Suffix:
Gender:F
Credentials:LCSW, LADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 958
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-0958
Mailing Address - Country:US
Mailing Address - Phone:207-319-2154
Mailing Address - Fax:
Practice Address - Street 1:8 OLD MILL ROAD THE OPEN DOOR RECOVERY CENTER
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605
Practice Address - Country:US
Practice Address - Phone:207-667-3210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELS103131041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool