TARA WALLER
NPI 1467208918
Social Worker - Clinical in Roanoke, VA

Q: What is Tara Waller's NPI number?

The NPI number for Tara Waller is 1467208918. It was assigned to this individual provider in the NPPES registry on April 25, 2024.

Q: What is Tara Waller's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: Is Tara Waller enrolled in Medicare?

No. Tara Waller has opted out of Medicare through September 26, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Tara Waller was last updated on April 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 25, 2024Opted out of Medicare · through Sep 26, 2026

1454 MEXICO WAY NE, ROANOKE, VA 24012(434) 533-1088(434) 664-1177 Get Directions Write a Review

NPPES record last updated: April 25, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Tara Waller NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TARA WALLER (NPI 1467208918) is an individual clinical provider in Roanoke, Virginia, licensed in Virginia (0904016744) and active in the NPI registry since April 2024. She has opted out of Medicare through September 26, 2026.

NPPES Registry Identity

NPI1467208918

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameTARA WALLER

Location Address1454 MEXICO WAY NERoanoke, VA 24012-6476

Mailing Address724 Shelbourne AveVinton, VA 24179-3720 · (304) 747-8587

Phone(434) 533-1088

Fax(434) 664-1177

Sole ProprietorNo

Enumeration DateApril 25, 2024

NPPES CertifiedApril 25, 2024

✔ NPI 1467208918 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in VA · 0904016744

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

1454 MEXICO WAY NE, Roanoke, VA 24012

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Tara Waller has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 26, 2024 through September 26, 2026.

Opt-Out Effective DateSeptember 26, 2024

Opt-Out In Effect ThroughSeptember 26, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. EMILY P. COONRADT LPTA, ATC

Physical Therapy Assistant