Brenda Odalys Tavara, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25911 Issued in MD

Practice address

220 Girard St # 100
Gaithersburg, MD 20877-3467

Phone

(301) 216-0880

Fax

(301) 495-0318

NPI assigned

Jun 30, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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 and National Provider Directory roles.

• Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gaithersburg, MD
  • NPI 1699817775
  NPD

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1841817467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8630 FENTON ST STE 1204",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103808",
            "telephone_number": "240-839-5811",
            "fax_number": "301-495-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 GIRARD ST # 100",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208773467",
            "telephone_number": "301-216-0880",
            "fax_number": "301-495-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVARA",
        "first_name": "BRENDA",
        "middle_name": "ODALYS",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "25911",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "25911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nazaarah.bell@cciweb.org",
            "affiliation": "N",
            "endpointDescription": "other",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "nazaarah.bell@cciweb.org",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "220 Girard St # 100",
            "city": "Gaithersburg",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208773467",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nazaarah.bell@cciweb.org",
            "affiliation": "N",
            "endpointDescription": "other",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "220 Girard St # 100",
            "city": "Gaithersburg",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208773467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shiyu Tang
• Francisco Tangan Jr.
• Rebecca V Tani, DPT
• Allyson Tarbox, LCSW-C
• Guy-Mark Tatiefo
• Sharon Maame Akua Essoun Tawiah, LCPC
• Taylor Speech & More LLC
• Sheena Taylor-Jones
• Kristi Laree Taylor-Sayles, LICSW, LWCW-C
• Abidjan Dmitri Taylor

• Clinical Social Worker in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.