Individual provider Active NPI

Dominique Thornton, MS, LCPC

  • Mental Health Counselor
  • Fort Washington, MD
National Provider Identifier
1053892950
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC15516 Issued in MD
Practice address
12102 Clear Creek Dr
Fort Washington, MD 20744-2758
Phone
(301) 597-9272
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC15516 MD Primary

Addresses

Primary practice location

12102 Clear Creek Dr
Fort Washington, MD 20744-2758

Mailing address

120 Waterfront St Ste 420
National Harbor, MD 20745-1122
Phone (301) 597-9272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LC15516MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Flow Therapy, LLC Mental Health CurrentSince Oct 20, 2024 Accepting new patients

Locations

120 Waterfront St
Ste 420
Oxon Hill, MD 20745
Phone (240) 647-8262

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1053892950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WATERFRONT ST STE 420",
            "city": "NATIONAL HARBOR",
            "state": "MD",
            "postal_code": "207451122",
            "telephone_number": "301-597-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12102 CLEAR CREEK DR",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207442758",
            "telephone_number": "301-597-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "DOMINIQUE",
        "credential": "MS, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC15516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.