Dominion ABA

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1654-07-004 Issued in VA

Legal business name

DOMINION ABA

Practice address

5408 Chamberlayne Rd
Richmond, VA 23227-2407

Phone

(804) 285-9838

Fax

(804) 285-9839

NPI assigned

May 16, 2012

Organization subpart

Yes

Parent organization

DOMINION YOUTH SERVICES RESIDENTIALAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. George Pulliam Jr., MS

Title

Director

Phone

(804) 285-9838

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Dominion ABA

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337126400000",
    "number": "1790045334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5408 CHAMBERLAYNE RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232272407",
            "telephone_number": "804-285-9838",
            "fax_number": "804-285-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5408 CHAMBERLAYNE RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232272407",
            "telephone_number": "804-285-9838",
            "fax_number": "804-285-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINION ABA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DOMINION YOUTH SERVICES RESIDENTIAL",
        "enumeration_date": "2012-05-16",
        "last_updated": "2012-05-16",
        "status": "A",
        "authorized_official_last_name": "PULLIAM",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "804-285-9838",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "1654-07-004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1654-07-004",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeisha L Doman, LCSW
• Evan Michael Dombrosky, MD
• Theresa Domhan-Adams
• Antonio Alberto Dominguez, MD
• Dominion ABA
• Dominion Behavioral Healthcare
• Dominion Behavioral Healthcare
• Dominion Cardiovascular Specialists LLC
• Dominion Chiropractic, Inc.
• Dominion Christian School for Autism

• Community/Behavioral Health Agency in Richmond, VA
• Providers in Richmond, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.