Provider Demographics
NPI:1942418215
Name:TALARICO-HOWARD, THOMAS VINCENT (LADC1)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:VINCENT
Last Name:TALARICO-HOWARD
Suffix:
Gender:M
Credentials:LADC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 ALLERTON COMMONS LN
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-8248
Mailing Address - Country:US
Mailing Address - Phone:781-848-6533
Mailing Address - Fax:
Practice Address - Street 1:549 COLUMBIAN ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1138
Practice Address - Country:US
Practice Address - Phone:781-331-1906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA277101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)