Individual
DR. CHARLES SHAWN OAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LMFT, LSW
Contact information
Practice address
2210 GOLDSMITH LN STE 104, LOUISVILLE, KY 40218-1038
(502) 792-0667
(502) 416-0467
Mailing address
3303 AUDUBON RIDGE DR, LOUISVILLE, KY 40213-1022
(502) 594-2829
(502) 416-0467
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33006299A
IN
106H00000X
Marriage & Family Therapist
Primary
104010
KY
106H00000X
Marriage & Family Therapist
35001769A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100320890
—
KY
Enumeration date
02/27/2007
Last updated
07/21/2022
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