Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tara Banks Wallace, PSYD

Individual provider Clinical Child & Adolescent Psychologist · NPI 1457644585

Tara Banks Wallace, PSYD is a Clinical Child & Adolescent Psychologist in Fairfax, Virginia. Practices as a sole proprietor. Licensed in Virginia.

Licensed in
VA
In the registry since
2011
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

See every abbreviation used in this directory →

Practice location Address checks out

8626 Lee Hwy Ste 200
Fairfax, VA 22031-2135
Phone: (571) 393-0075
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Child & Adolescent Psychologist (primary) Taxonomy 103TC2200X · Licence 0810004361 (VA)

Record details

NPI number1457644585
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD
Sole proprietorYes
NPI enumeratedMay 23, 2011
Last updated in NPPESMay 23, 2011

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