Provider Demographics
NPI:1871391706
Name:ECHOLS, TARA LOUISE (RBT)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:LOUISE
Last Name:ECHOLS
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:LOUISE
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 DAY ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23661-2306
Mailing Address - Country:US
Mailing Address - Phone:804-551-3447
Mailing Address - Fax:
Practice Address - Street 1:739 THIMBLE SHOALS BLVD STE 302
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3562
Practice Address - Country:US
Practice Address - Phone:757-690-9390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARBT-25-415101106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician