TARA CANAVAN LADCI NPI 1205284395

NPI Information

NPI: 1205284395
Provider Name: TARA CANAVAN, LADCI
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
30 MEADOWBROOK RD
OTP
BROCKTON, MA
ZIP 02301
Phone: (508) 742-4400
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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
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	14001	MASSACHUSETTS	Yes

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: 4/28/2024

NPI Synchronization or Removal

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