Basic Information
| Provider Information | |||||||||
| NPI: | 1134146897 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOTAS | ||||||||
| FirstName: | ELLEN | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 644 UNIVERSITY BLVD STE B | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228013773 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405647007 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 644 UNIVERSITY BLVD | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228013750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405645100 | ||||||||
| FaxNumber: | 7575798573 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 09/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 0701003262 | VA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 11525913 | 01 | VA | CAQH PROVIDER NUMBER | OTHER | 279977 | 01 | VA | ANTHEM PROVIDER NUMBER | OTHER | 1134146897 | 05 | VA | MEDICAID | 592882 | 01 | VA | VALUE OPTIONS PROVIDER NUMBER | OTHER | C05754 | 01 | VA | MEDICARE GROUP NUMBER | OTHER | 187228 | 01 | VA | COMPSYCH PROVIDER NUMBER | OTHER | 088409 | 01 | VA | SENTARA | OTHER | 2356158 | 01 | VA | CIGNA PROVIDER NUMBER | OTHER | 1417027608 | 01 | VA | RMH GROUP NPI NUMBER | OTHER |