TARA CANAVAN LADCI NPI 1205284395

NPI Information

  • NPI: 1205284395
  • Provider Name: TARA CANAVAN, LADCI
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 30 MEADOWBROOK RD
    OTP
    BROCKTON, MA
    ZIP 02301
  • Phone: (508) 742-4400

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NPI Details

Tara Canavan, LADCI is an addiction (substance use disorder) counselor in Brockton, MA. Tara Canavan, LADCI NPI is 1205284395. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

30 MEADOWBROOK RD
OTP
BROCKTON, MA
ZIP 02301-122
Phone: (508) 742-4400

The enumeration date for this NPI number is 5/30/2016 and was last updated on 5/30/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)14001MASSACHUSETTSYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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