Tara D Nelson, CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0709024731 Issued in VA

Practice address

316 S Main St
Woodstock, VA 22664-1254

Phone

(540) 908-8585

NPI assigned

Sep 9, 2022

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

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Life Enrichment Services, LLC

  • Mental Health Counselor
  • Broadway, VA
  • NPI 1912440116
  NPD

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1891416517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 S MAIN ST",
            "city": "WOODSTOCK",
            "state": "VA",
            "postal_code": "226641254",
            "telephone_number": "540-325-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 S MAIN ST",
            "city": "WOODSTOCK",
            "state": "VA",
            "postal_code": "226641254",
            "telephone_number": "540-908-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TARA",
        "middle_name": "D",
        "credential": "CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0709024731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSAC LICENSE",
            "identifier": "0709024731",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.lifeenrichmentservices.org",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "website registration",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "program services",
            "address_1": "316 S Main St",
            "city": "Woodstock",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226641254",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.lifeenrichmentservices.org",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "program services",
            "address_1": "316 S Main St",
            "city": "Woodstock",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226641254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Claudia Hilburn Methvin, MD
• Lindsey M Miller
• Nancy L. Miller, PHARMD
• Jennifer Mooney
• Susan Carol Moose, DO
• Anthony Robert Neri, MD
• Rodolfo Nicdao, PT
• Jonathan F O'Neal, M.D
• One Heart Medical PLLC
• Stephen F Palmerton, CRNA

• Addiction (Substance Use Disorder) Counselor in Woodstock, VA
• Providers in Woodstock, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.