MEDICARE: MS. DONNA F. TARVER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	7528	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7528	OTHER	TX	STATE LICENSING BOARD

General Provider Information

NPI Number	:	1811054331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DONNA F. TARVER LCSW

Provider Business Mailing Address
First Line	:	10260 N CENTRAL EXPY STE 217
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-3443
Country	:	US
Telephone Number	:	214-691-2171
Fax Number	:

Provider Business Practice Location Address
First Line	:	10260 N CENTRAL EXPY STE 217
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-3443
Country	:	US
Telephone Number	:	214-691-2171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	06/01/2020

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