Tara Southall, BCABA

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

0134000265 Issued in VA

Practice address

1314 Riverland Rd SE
Roanoke, VA 24014-3610

Phone

(540) 566-3670

NPI assigned

Nov 22, 2016

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": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1770026825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CROSS CREEK CIR",
            "city": "CLOVERDALE",
            "state": "VA",
            "postal_code": "240773038",
            "telephone_number": "540-272-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 RIVERLAND RD SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240143610",
            "telephone_number": "540-566-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHALL",
        "first_name": "TARA",
        "credential": "BCABA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-22",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "VA",
            "license": "0134000265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Usha Soundarapandian, MD
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• Catherine Blair South, PT, DPT
• David Southall, LPC
• Molly Amelia Southard, RBT
• Sarah Southard, NP
• Southeastern Optical, Inc.
• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.

• Assistant Behavior Analyst in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Assistant Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; 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.