Active NPI
Olivia Lakes, LICSW
- Clinical Social Worker
- Boston, MA
National Provider Identifier
1043964133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LICSW1120799
- Practice address
- 1 Boston Medical Ctr PL
Boston, MA 02118-2908 - Phone
- (617) 414-5245
- Fax
- (617) 414-5520
- NPI assigned
- Feb 8, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LICSW1120799 | MA | Primary |
| Clinical Social Worker | 1041C0700X | LC200002485 | DC |
Addresses
Primary practice location
1 Boston Medical Ctr PL
Boston, MA 02118-2908
Mailing address
960 Massachusetts Ave Ste 2
Boston, MA 02118-2690
Other practice location 1
2201 18th St NW
Washington, DC 20009-1812
Phone (857) 212-3444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC200002485 | DC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1043964133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 MASSACHUSETTS AVE STE 2",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BOSTON MEDICAL CTR PL",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182908",
"telephone_number": "617-414-5245",
"fax_number": "617-414-5520"
}
],
"practiceLocations": [
{
"address_1": "2201 18th St NW",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200091812",
"country_code": "US",
"telephone_number": "857-212-3444",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAKES",
"first_name": "OLIVIA",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-08",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "LICSW1120799",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC200002485",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.