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General NPI Number Information
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NPI Number | 1497403109
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Entity Type | Individual
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Provider Name | TARA SUE LANOIR LICSW
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Gender | Female
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Dates
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Enumeration Date | 03/11/2022
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 30 PERWAL ST
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City | WESTWOOD
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State | MA
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Zip | 02090-1928
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Country | US
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Telephone | 860-877-6672
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Fax |
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Provider Business Mailing Address
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Address Line | 64 SCHOOL ST
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City | MARION
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State | CT
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Zip | 06444-0010
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Country | US
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Telephone | 860-877-6672
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Fax | 617-789-3206
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 124711
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 000225468
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License Number State | MA
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