Provider Demographics
NPI:1235464421
Name:DAKIN, SCOTT THOMAS (LICSW)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:THOMAS
Last Name:DAKIN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 COLBY RD APT 2
Mailing Address - Street 2:
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-7919
Mailing Address - Country:US
Mailing Address - Phone:608-219-1735
Mailing Address - Fax:
Practice Address - Street 1:7 COLBY RD APT 2
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-7919
Practice Address - Country:US
Practice Address - Phone:608-219-1735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1283361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty