Individual
LINDA TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
520 HOPE ST, PROVIDENCE, RI 02906-2532
(401) 276-4155
Mailing address
528 N MAIN ST, PROVIDENCE, RI 02904-5757
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00246
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104847946
THE PROVIDENCE CENTER NPI
RI
01
—
29655-9
BLUE CROSS
RI
01
—
412685
BLUE CHIP
RI
01
—
62-81698
UNITED BEHAVIORAL HEALTH
RI
05
—
LB56517
—
RI
Enumeration date
06/29/2006
Last updated
09/15/2016
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