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MISS TARA NICOLE RUSSELL MS BCBA LBA NPI 1649429465


NPI Information

NPI: 1649429465
Provider Name: MISS TARA NICOLE RUSSELL, MS, BCBA, LBA
Classification: Behavior Analyst - 103K00000X
Entity Type: Individual
Address:
6550 E BROADWAY RD STE 110
MESA, AZ
ZIP 85206
Phone: (480) 672-0772
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MISS Tara Nicole Russell, MS, BCBA, LBA is a behavior analyst in Mesa, AZ. The provider is a behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. MISS Tara Nicole Russell, MS, BCBA, LBA NPI is 1649429465. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6550 E BROADWAY RD STE 110
MESA, AZ
ZIP 85206-734
Phone: (480) 672-0772
Fax: (317) 520-8200

The enumeration date for this NPI number is 9/17/2008 and was last updated on 5/1/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2103K00000XBehavior AnalystBEH-000896ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11-21-48060OTHERBCBA CERTIFICATE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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