Ana Virginia Taveras

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5884 Issued in CT

Practice address

968 Fairfield Ave
Bridgeport, CT 06605-1116

Phone

(203) 330-6000

NPI assigned

Dec 22, 2021

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 CT

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

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.

• South-West Community Health Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bridgeport, CT
  • NPI 1699703686
  Medicare reassignment NPD
• Rubix Solutions, LLC

  • Professional Counselor
  • Monroe, CT
  • NPI 1962111948
  NPD Authorized official

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

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1164182853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 ALBION ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052602",
            "telephone_number": "203-330-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "968 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051116",
            "telephone_number": "203-330-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERAS",
        "first_name": "ANA",
        "middle_name": "VIRGINIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-22",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "5884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Buadi Kofi Tandoh, MD
• Stacey Ilona Tapia, MA
• James Tautkus, MD
• Janice Tavares, APRN
• Ada Ely Tavarez-Perez, LMSW
• Shady Taveras, PMHNP
• Carla Taylor
• Carolyn Taylor
• Hope Taylor, LPC
• Jessica Taylor, LCSW

• Professional Counselor in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.