Elizabeth Domack LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

ELIZABETH DOMACK LLC

Practice address

57 Plains Rd Ste 3C
Milford, CT 06461-2573

Phone

(860) 309-8334

NPI assigned

Oct 1, 2019

Organization subpart

No

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

Authorized official

Name

Elizabeth Domack, LPCNPI 1225405152

Title

Owner

Phone

(860) 309-8334

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth Domack, LPC

  • Professional Counselor
  • Bridgeport, CT
  • NPI 1225405152
  NPD Authorized official

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569888000000",
    "number": "1013558022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 RIMMON RD",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 PLAINS RD STE 3C",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064612573",
            "telephone_number": "860-309-8334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH DOMACK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-01",
        "last_updated": "2019-10-01",
        "status": "A",
        "authorized_official_last_name": "DOMACK",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-309-8334",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225405152",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.psychologytoday.com/us/therapists/elizabeth-domack-milford-ct/386762",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "57 Plains Rd Ste 3C",
            "city": "Milford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064612573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eliana Echeverry, M.A. CCC-SLP
• Deloretta Theresa Eckenrode, NP
• Yolani P Edirisinghe, DMD
• Luke Joseph Edmondson
• Richard Kevin Edwards, APRN
• Melissa Emmanuel, LPC
• Empowering Marriage & Family Therapy LLC
• Endodontic Associates
• Kayla Eng
• Thomas Eng, O.D.

• Professional Counselor in Milford, CT
• Providers in Milford, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.