=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558835322
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOTSON THERAPY AND ASSOCIATES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/15/2019
-----------------------------------------------------
Last Update Date | 06/28/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3815 RIVER CROSSING PKWY STE 100
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46240-7766
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-675-0233
-----------------------------------------------------
Fax | 317-344-8291
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3815 RIVER CROSSING PKWY STE 100
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46240-7766
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-675-0233
-----------------------------------------------------
Fax | 317-344-8291
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/THERAPIST
-----------------------------------------------------
Name | MRS. MEILSSA DOTSON
-----------------------------------------------------
Credential | LMHC
-----------------------------------------------------
Telephone | 317-675-0233
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------