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General NPI Number Information
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NPI Number | 1275600710
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Entity Type | Individual
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Provider Name | GIOIA M. TANGO LMHC, LADC-I
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 34 COURT ST SUITE # 3
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City | PLYMOUTH
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State | MA
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Zip | 02360-8721
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Country | US
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Telephone | 508-878-7040
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Fax |
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Provider Business Mailing Address
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Address Line | 754 LONG POND RD
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City | PLYMOUTH
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State | MA
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Zip | 02360-2625
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Country | US
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Telephone | 508-878-7040
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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