Dominic Christepher Lathos

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1300 NW Harrison Blvd
Corvallis, OR 97330-6277

Phone

(541) 203-0485

Fax

(541) 833-6656

NPI assigned

Mar 2, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Transformative Health and Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Corvallis, OR
  • NPI 1972246502
  Medicare reassignment NPD

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1043844848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 NW HARRISON BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973306277",
            "telephone_number": "541-203-0485",
            "fax_number": "541-833-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 NW HARRISON BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973306277",
            "telephone_number": "541-203-0485",
            "fax_number": "541-833-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHOS",
        "first_name": "DOMINIC",
        "middle_name": "CHRISTEPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-02",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Larsen, LMT
• Joseph Ryan Larson, CADC-R
• Kate Larson, LMT
• Sarah Ruth Laster, D.D.S.
• Tommy Gale Laster Jr., D.D.S.
• Victoria Ellen Lathos
• Austin F Lau, PHD
• Mimi Raychelle Launder-Bryson
• Lauren Sletta, LPC, LLC
• Linda S Lavallee Conniff, MSW

• Professional Counselor in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.