Tara Wu, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701009680 Issued in VA

Practice address

611 McDowell Ave NW
Roanoke, VA 24016-1225

Phone

(540) 266-9200

Fax

(540) 266-9205

NPI assigned

Jul 29, 2020

Sex

Female

Sole proprietor

No

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

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.

• Blue Ridge Behavioral Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Roanoke, VA
  • NPI 1437137734
  Medicare reassignment NPD

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1447869052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6219 MONET DR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240185290",
            "telephone_number": "540-793-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 MCDOWELL AVE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240161225",
            "telephone_number": "540-266-9200",
            "fax_number": "540-266-9205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "TARA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701009680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandy Mae Wright, MT-BC
• Savannah E Wright, PA-C
• Juliet Adobea Wryter, DDS
• WSSH Powerback Rehabilitation Services, LLC
• Kainuo Wu
• Winston Wu, MD
• Ashley Wyatt
• David A Wyatt, MD
• Kristin Marie Wyatt, PA-C
• Leslie Hutchison Wyatt, ACNP-BC

• 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 Jul 29, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.