TARA CANAVAN


Address: 30 Meadowbrook Rd, Otp, Brockton, MA 02301-7122
Phone: 5087424400

TARA CANAVAN (NPI# 1205284395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205284395
Entity Type Individual
Full Name TARA CANAVAN
Credential LADCI
Practice Address 30 Meadowbrook Rd
Otp
Brockton
MA 02301-7122
Practice Telephone 5087424400
Enumeration Date 2016-05-30
Last Update Date 2016-05-30
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
14001 MA Behavioral Health & Social Service Providers

Office Location

Street Address 30 MEADOWBROOK RD
OTP
City BROCKTON
State MA
Zip Code 02301-7122

Providers in the same location

NPI Name Taxonomy Address Enumeration
1740386689 Miriam Tankiang Villanueva Psychiatry & Neurology 30 Meadowbrook Rd, Brockton, MA 02301-7122 2006-09-16
1457901316 Dellarita L Jones Counselor 30 Meadowbrook Rd, Brockton, MA 02301-7122 2019-09-12
1093361495 Allison Marie Bulger Counselor 30 Meadowbrook Rd, Brockton, MA 02301-7122 2019-08-13
1821643487 Stephanie Calandra Jones Counselor 30 Meadowbrook Rd, Brockton, MA 02301-7122 2019-08-09
1164987269 Stephen Miller Counselor 30 Meadowbrook Rd, Brockton, MA 02301-7122 2019-02-04
1518438944 Andrew Duff Bell Social Worker 30 Meadowbrook Rd, Brockton, MA 02301-7122 2018-12-11
1730687575 James Albert Parker Sr. Counselor 30 Meadowbrook Rd, Brockton, MA 02301-7122 2018-01-26
1558878728 Darlene Diggs Social Worker 30 Meadowbrook Rd, Brockton, MA 02301-7122 2018-01-09
1336659895 Danielle Aurora Lasden Nurse Practitioner 30 Meadowbrook Rd, Brockton, MA 02301-7122 2017-10-10
1538517685 Justine Doucette Counselor 30 Meadowbrook Rd, Brockton, MA 02301 2016-05-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1942807110 Jenny Vulpis Recreation Therapist 940 Belmont St (br 135), Brockton, MA 02301 2020-10-01
1205444924 Caroline Storey Counselor Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 2020-07-20
1013546852 Nuria Dos Santos Veiga Occupational Therapist 73 Denton St, Brockton, MA 02301 2020-04-03
1679113930 Laura Ann Brondyk II Counselor 10 Christys Dr, Brockton, MA 02301 2020-01-14
1437796521 Andrea Lopes Developmental Therapist 7 Goddard Road, Brockton, MA 02301 2019-12-08
1518420124 Diligencehealthcare Psychiatry & Neurology 30-40 Westpark Street, Brockton, MA 02301 2019-04-10
1124530373 Rachel Theys Behavioral Analyst 130 Liberty St Ste 13a, Brockton, MA 02301 2017-10-27
1689193369 Anderson D Delgado Behavior Technician 11 Packard Way, Brockton, MA 02301 2017-09-14
1811415326 Francesca Lavecchia Clinical Neuropsychologist Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 2017-09-05
1831615343 Donna Marie Dugan Counselor South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 2017-08-16
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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1205444924 Caroline Storey Counselor Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 2020-07-20
1720540156 Nicilda Dejesus Counselor 204 Chatham West Dr, Brockton, MA 02301-1314 2019-04-04
1285160838 Maria Atherton Jr. Counselor 17 Snell St, Brockton, MA 02301-1644 2017-05-02
1467726398 Carin Rhodes Counselor 1115 W Chestnut St Ste 101, Brockton, MA 02301-7501 2012-02-23
1073817573 Daniel Mendes Depina Counselor 682 North Main Street, Apt. 308, Brockton, MA 02301-3626 2010-12-27
1063713402 Judith R Chaskes Counselor 30 Meadowbrook Road, Brockton, MA 02301 2010-11-16
1093957185 Jerome P Posey Counselor 1311 Main St, Brockton, MA 02301-7109 2009-04-03
1548441587 Sylvester Pereira Fortes Counselor 20 Hope St, Brockton, MA 02302-3415 2007-11-19
1184817579 George Hamilton Brickhouse Jr. Counselor 108 Centre Street, Brockton, MA 02302 2007-08-20
1720282130 Kathleen Mary Mckenna Counselor 225 Liberty St, Brockton, MA 02301-5571 2007-06-12
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Competitor

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City BROCKTON
Zip Code 02301

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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