Tavares Bostic, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C010090 Issued in NC

Practice address

102 W Main St
Suite a
Whiteville, NC 28472-4012

Phone

(910) 642-7463

NPI assigned

Mar 17, 2014

Last updated

Jun 23, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bostic Counseling & Consulting

  • Clinical Social Worker
  • Rockingham, NC
  • NPI 1104372424
  NPD (past) Authorized official
• Premier Counseling

  • Community/Behavioral Health Agency
  • Rockingham, NC
  • NPI 1396293957
  Authorized official Same address or phone
• Premier Counseling Group PLLC

  • Community/Behavioral Health Agency
  • Marston, NC
  • NPI 1104364835
  NPD (past) Authorized official
• Pace Health Network, LLC

  • Psychiatry Physician
  • Whiteville, NC
  • NPI 1063960904
  NPD

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1134545908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 STROMAN RD",
            "city": "MARSTON",
            "state": "NC",
            "postal_code": "283639501",
            "telephone_number": "585-967-8396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W MAIN ST",
            "address_2": "SUITE A",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284724012",
            "telephone_number": "910-642-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTIC",
        "first_name": "TAVARES",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-17",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grant Bishop, DPT
• Courtney Briann Blackledge, LCMHCA
• Tonia Blackwell, FNP
• Viola Elizabeth Blackwell, FNP-C
• Bladen Healthcare LLC (CFV Primary Care-Vineland Family Medicine)
• James E Boston, MD
• Kayla Bowen, LPC-A
• Christian Boyd, FNP-C
• Breathe Ez, Inc
• Brighter Day Health LLC

• Clinical Social Worker in Whiteville, NC
• Providers in Whiteville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.