| Sara M Tavora, LMSW | |
|
520 Superior St, Port Huron, MI 48060-3838 | |
| (810) 984-4202 | |
| (810) 984-8896 |
| Full Name | Sara M Tavora |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 520 Superior St, Port Huron, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003001819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801089286 (Michigan) | Primary |
| Entity Name | Professional Counseling Center,p.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225049760 PECOS PAC ID: 1759370208 Enrollment ID: O20040610001450 |
| Entity Name | Blue Water Mental Health Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457305419 PECOS PAC ID: 2769477264 Enrollment ID: O20060531000214 |
| Mailing Address | Practice Location Address |
|---|---|
| Sara M Tavora, LMSW 520 Superior St, Port Huron, MI 48060-3838 Ph: (810) 984-4202 | Sara M Tavora, LMSW 520 Superior St, Port Huron, MI 48060-3838 Ph: (810) 984-4202 |
Heather Stewart, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Callie Gunn, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Mr. Robert Marshall Ii, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Kristen M Azzinaro, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Mrs. Deborah Louise Kokoszka, LMSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Ms. Erin Michelle Mcdaid, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2601 13th St, Port Huron, MI 48060 Phone: 810-987-9100 Fax: 810-987-9105 |