Individual provider Active NPI

Tara Sanabria Davila, LCSW

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1063607133
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
005953 Issued in CT
Practice address
93 Edwards St
Clifford Beers Clinic
New Haven, CT 06511-3933
Phone
(203) 772-1270
Fax
(203) 772-0051
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 005953 CT Primary

Addresses

Primary practice location

93 Edwards St
Clifford Beers Clinic
New Haven, CT 06511-3933

Mailing address

93 Edwards St
Clifford Beers Clinic
New Haven, CT 06511-3933
Phone (203) 772-1270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005953CTMDClinical Social Worker
5953CTMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1063607133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 EDWARDS ST",
            "address_2": "CLIFFORD BEERS CLINIC",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113933",
            "telephone_number": "203-772-1270",
            "fax_number": "203-772-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 EDWARDS ST",
            "address_2": "CLIFFORD BEERS CLINIC",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113933",
            "telephone_number": "203-772-1270",
            "fax_number": "203-772-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "TARA",
        "middle_name": "SANABRIA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.