NPIMap

Organization Active NPI

Wall Therapeutic Solutions, LLC

Doing business as Wall Therapeutic Solutions

  • Behavior Analyst
  • Salem, VA
National Provider Identifier
1558087999
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
WALL THERAPEUTIC SOLUTIONS, LLC
Doing business as
Wall Therapeutic Solutions
Practice address
405 Yorkshire St
Salem, VA 24153-7016
Phone
(540) 387-4517
Fax
(540) 579-0414
NPI assigned
Oct 18, 2022
Last updated
Oct 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Authorized official

Name
Mr. Matthew Rosenbaum
Title
Treasurer
Phone
(540) 285-0423

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Developmental Disabilities Clinic/Center 261QD1600X
Hearing and Speech Clinic/Center 261QH0700X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

405 Yorkshire St
Salem, VA 24153-7016

Mailing address

405 Yorkshire St
Salem, VA 24153-7016
Phone (540) 387-4517

Other names 1

  • Wall Therapeutic Solutions Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL IntakeQ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241116000280 VA Part B Supplier - Clinic/Group Practice 8820522543 Receives reassigned benefits from 2 practitioners
Practice locations: Salem, VA; Madison Heights, VA; Danville, VA

National Provider Directory

National Provider Directory

Locations

8 Radford St
Ste 102B
Christiansbrg, VA 24073

8 Radford St
Christiansburg, VA 24073
Phone (304) 320-0663

157 Dillard Rd
Madison Heights, VA 24572
Phone (434) 660-0958

405 Yorkshire St
Salem, VA 24153
Phone (540) 285-0523

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1558087999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 YORKSHIRE ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537016",
            "telephone_number": "540-387-4517",
            "fax_number": "540-579-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 YORKSHIRE ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537016",
            "telephone_number": "540-387-4517",
            "fax_number": "540-579-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALL THERAPEUTIC SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "ROSENBAUM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "540-285-0423",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "IntakeQ",
            "affiliation": "N",
            "endpointDescription": "Electronic Health Record",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "405 Yorkshire St",
            "city": "Salem",
            "state": "VA",
            "country_code": "US",
            "postal_code": "241537016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Wall Therapeutic Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.