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

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

State licenses

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 and National Provider Directory roles.

• Riverside Counseling Richmond PLLC

  • 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 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.

• 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.