Healthcare Provider Details

I. General information

NPI: 1760411177
Provider Name (Legal Business Name): ELLEN MYOKO SINGER MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 ROSE HILL DR SUITE 201
CHARLOTTESVILLE VA
22903-5159
US

IV. Provider business mailing address

1110 ROSE HILL DR STE 201
CHARLOTTESVILLE VA
22903-5159
US

V. Phone/Fax

Practice location:
  • Phone: 434-906-0830
  • Fax:
Mailing address:
  • Phone: 434-220-3334
  • Fax: 434-220-3335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701003985
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: