Provider Demographics
NPI:1497426712
Name:LAFRAMBOISE, TARA (LLMSW, CADC)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:LAFRAMBOISE
Suffix:
Gender:F
Credentials:LLMSW, CADC
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA, CPRC
Mailing Address - Street 1:3773 ROGERS RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-8703
Mailing Address - Country:US
Mailing Address - Phone:989-708-0881
Mailing Address - Fax:989-631-0242
Practice Address - Street 1:133 N SAGINAW RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-3350
Practice Address - Country:US
Practice Address - Phone:989-631-0241
Practice Address - Fax:989-631-0242
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2-01785101YA0400X
390200000X
MI68511148051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program