Tara Fasanello, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

0131000874 Issued in VA

Practice address

12628 Fair Crest CT
Fairfax, VA 22033-3888

Phone

(724) 664-4521

NPI assigned

Jan 5, 2015

Last updated

Jan 5, 2015By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1346638079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12628 FAIR CREST CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12628 FAIR CREST CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333888",
            "telephone_number": "724-664-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASANELLO",
        "first_name": "TARA",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131000874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle D Farquhar
• Monica A Farrar, MS, LPC, LMHC, CSAC
• Natalie Farrell
• Allie Farris, ED.S.
• Christian Fary
• Fasika Waldearegay MD PLLC
• Stephen P Fassnacht, DDS
• Fast Trans LLC
• Andrea J. Fata, LPC
• Monica Anahita Fathipour Jalilian

• Occupational Therapy Assistant in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Occupational Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.