Individual provider Active NPI

Kiara Ines Taveras, LICSW

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1306525027
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW04353 Issued in RI
Practice address
111 Wayland Ave
Providence, RI 02906-4371
Phone
(401) 396-7649
Fax
(401) 208-2482
NPI assigned
Jul 12, 2023
Last updated
Feb 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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 ISW04353 RI Primary

Addresses

Primary practice location

111 Wayland Ave
Providence, RI 02906-4371

Mailing address

111 Wayland Ave
Providence, RI 02906-4371
Phone (401) 396-7649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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

Enrollment IDStateProvider typePAC IDDetails
I20250414000230 RI Practitioner - Clinical Social Worker 3072037969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inner You LLCGroup PAC ID 7113241142, 7 clinicians

Practice addresses (Care Compare)

1023 Post Rd
Warwick, RI 02888-3363
Phone (401) 773-7116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW04353RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Diversity Counseling LLC CurrentSince Dec 1, 2023 Accepting new patients
Dr Joanne L Doucette Psychological Services Inc CurrentSince Jul 16, 2023 Accepting new patients
Inner You LLC Clinical CurrentSince Mar 1, 2025 Accepting new patients
The Inner You Clinical Past Accepting new patients

Locations

111 Wayland Ave
Providence, RI 02906
Phone (401) 396-7649

1023 Post Rd
Warwick, RI 02888
Phone (401) 773-7116

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1306525027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WAYLAND AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064371",
            "telephone_number": "401-396-7649",
            "fax_number": "401-208-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WAYLAND AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064371",
            "telephone_number": "401-396-7649",
            "fax_number": "401-208-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERAS",
        "first_name": "KIARA",
        "middle_name": "INES",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW04353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.