Sara M Tavora, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801089286 Issued in MI

Practice address

520 Superior St
Port Huron, MI 48060-3838

Phone

(810) 984-4202

Fax

(810) 984-8896

NPI assigned

Sep 14, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Blue Water Mental Health ClinicGroup PAC ID 2769477264, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Blue Water Mental Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Gratiot, MI
  • NPI 1457305419

  Clinical

  Medicare reassignment Care Compare group NPD
• Professional Counseling Center,P.C.

  • Addiction (Substance Use Disorder) Counselor
  • Port Huron, MI
  • NPI 1225049760
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1003001819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603838",
            "telephone_number": "810-984-4202",
            "fax_number": "810-984-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603838",
            "telephone_number": "810-984-4202",
            "fax_number": "810-984-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVORA",
        "first_name": "SARA",
        "middle_name": "M",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801089286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Tan, DO
• Jose G. Tandoc, CRNA
• Hernani S Tansuche, MD
• Lisa Tate, LLMSW
• Andrea Taube
• Breonna Taylor
• Carrie Taylor, LPC
• Laura Elizabeth Taylor
• Matthew A Taylor, R.PH.
• Melissa Kay Taylor

• Clinical Social Worker in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.