Provider Demographics
NPI:1497403109
Name:LANOIR, TARA SUE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:SUE
Last Name:LANOIR
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 1:64 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:CT
Mailing Address - Zip Code:06444-0010
Mailing Address - Country:US
Mailing Address - Phone:860-877-6672
Mailing Address - Fax:617-789-3206
Practice Address - Street 1:30 PERWAL ST
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-1928
Practice Address - Country:US
Practice Address - Phone:860-877-6672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1247111041C0700X
MA0002254681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty