Individual provider Active NPI

Adrian Miguel Cruz Taveras, MSW

  • Clinical Social Worker
  • Cranston, RI
National Provider Identifier
1467173633
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW04555 Issued in RI
Practice address
941 Park Ave
Cranston, RI 02910-2721
Phone
(347) 661-2759
NPI assigned
Sep 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 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 ISW04555 RI Primary

Addresses

Primary practice location

941 Park Ave
Cranston, RI 02910-2721

Mailing address

941 Park Ave
Cranston, RI 02910-2721

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260218002733 CT Practitioner - Clinical Social Worker 6901386853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Montauk Ave
New London, CT 06320-4967

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW04555RIMDClinical Social Worker
15774CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Council on Alcoholism and Drug Dependence Inc CurrentSince Oct 31, 2025 Accepting new patients
Southeastern Council on Alcoholism and Drug Dependence Inc CurrentSince Oct 31, 2025 Accepting new patients
Counseling and Psychotherapy Center of Greater Boston, Inc. Past Accepting new patients

Locations

37 Camp Moween Rd
Lebanon, CT 06249
Phone (860) 886-2495

1 Montauk Ave
New London, CT 06320

47 Coit St
New London, CT 06320
Phone (860) 294-9586

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1467173633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 PARK AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029102721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 PARK AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029102721",
            "telephone_number": "347-661-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ TAVERAS",
        "first_name": "ADRIAN",
        "middle_name": "MIGUEL",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-07",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW04555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.