Provider Demographics
NPI:1306525027
Name:TAVERAS, KIARA INES (LICSW)
Entity type:Individual
Prefix:
First Name:KIARA
Middle Name:INES
Last Name:TAVERAS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WAYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4371
Mailing Address - Country:US
Mailing Address - Phone:401-396-7649
Mailing Address - Fax:401-208-2482
Practice Address - Street 1:111 WAYLAND AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4371
Practice Address - Country:US
Practice Address - Phone:401-396-7649
Practice Address - Fax:401-208-2482
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW043531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical