David Southall, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701011817 Issued in VA

Practice address

3807 Brandon Ave SW # 1115
Roanoke, VA 24018-1490

Phone

(540) 342-1261

NPI assigned

Oct 6, 2022

Last updated

Oct 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riverside Counseling Richmond PLLCGroup PAC ID 1355886821, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Riverside Counseling Richmond PLLC

  dba RVA Counseling

  • Clinical Social Worker
  • Henrico, VA
  • NPI 1407492895

  Professional

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1245955731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3807 BRANDON AVE SW # 1115",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181490",
            "telephone_number": "540-342-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3807 BRANDON AVE SW # 1115",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181490",
            "telephone_number": "540-342-1261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 Cambria St NE",
            "address_purpose": "LOCATION",
            "city": "Christiansburg",
            "state": "VA",
            "postal_code": "240731631",
            "country_code": "US",
            "telephone_number": "540-342-1261",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 N Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Galax",
            "state": "VA",
            "postal_code": "243332858",
            "country_code": "US",
            "telephone_number": "276-601-2904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUTHALL",
        "first_name": "DAVID",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701011817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sound Mind Behavioral Clinic
• Usha Soundarapandian, MD
• South Roanoke Life Care, LLC (South Roanoke Nursing Home)
• South Roanoke OB-GYN PC
• Catherine Blair South, PT, DPT
• Tara Southall, BCABA
• Molly Amelia Southard, RBT
• Sarah Southard, NP
• Southeastern Optical, Inc.
• Southern Home Care Services, Inc. (ResCare Home Care)

• Professional Counselor in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.