Provider Demographics
NPI:1730534694
Name:TALAVERA, CARLA (CADC)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:TALAVERA
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CADC
Mailing Address - Street 1:144 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-1368
Mailing Address - Country:US
Mailing Address - Phone:859-270-4351
Mailing Address - Fax:
Practice Address - Street 1:144 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-1368
Practice Address - Country:US
Practice Address - Phone:859-270-4351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)