Individual provider Active NPI

Kelly M Dominic, LMFT

  • Marriage & Family Therapist
  • Lancaster, OH
National Provider Identifier
1073007985
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
F.2200291 Issued in OH
Practice address
408 N Columbus St
Lancaster, OH 43130-3033
Phone
(740) 206-8659
Fax
(614) 437-2580
NPI assigned
Jun 15, 2018
Last updated
Apr 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X F.2200291 OH Primary

Addresses

Primary practice location

408 N Columbus St
Lancaster, OH 43130-3033

Mailing address

10955 Clearport Rd SW
Amanda, OH 43102-9612
Phone (330) 730-9511

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ohioguidestone CurrentSince Jan 1, 2024 Accepting new patients
Ohioguidestone CurrentSince Jan 1, 2024 Accepting new patients
Ohioguidestone Current Accepting new patients
Kelly Dominic, Imft LLC CurrentSince Mar 19, 2023 Accepting new patients

Locations

202 E Bagley Rd
Berea, OH 44017
Phone (440) 260-8327

434 Eastland Rd
Berea, OH 44017
Phone (440) 260-8327

195 N Grant Ave
Ste 250
Columbus, OH 43215
Phone (440) 260-6408

111 S Broad St
Ste 209
Lancaster, OH 43130
Phone (614) 301-6479

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1073007985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10955 CLEARPORT RD SW",
            "city": "AMANDA",
            "state": "OH",
            "postal_code": "431029612",
            "telephone_number": "330-730-9511",
            "fax_number": "614-437-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N COLUMBUS ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303033",
            "telephone_number": "740-206-8659",
            "fax_number": "614-437-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINIC",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "F.2200291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.