Migdalia Dominguez, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW19513 Issued in FL

Practice address

1205 Oxford Way
Cocoa, FL 32922-6445

Phone

(612) 310-0424

NPI assigned

Aug 20, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN, FL, TX, AZ4 enrollments

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 4

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: migdalia.dominguez.1@30520.direct.athenahealth.com

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AZ, Clinical, MN, TX

  Medicare reassignment Care Compare group NPD
• Doctor on Demand Professionals P C

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1174931448

  FL

  Medicare reassignment NPD
• Shoreview Mental Health Center, LLC

  • Psychologist
  • Shoreview, MN
  • NPI 1558735779
  Medicare reassignment NPD
• Kintsugi Therapy Services

  • Clinical Social Worker
  • Cocoa, FL
  • NPI 1083198741
  NPD Authorized official

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

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1114472008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 OXFORD WAY",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329226445",
            "telephone_number": "612-310-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 OXFORD WAY",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329226445",
            "telephone_number": "612-310-0424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "618 29th Ave N",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554111406",
            "country_code": "US",
            "telephone_number": "612-279-8677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "MIGDALIA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-20",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "24558",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.kintsugitherapyservices.com/",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1205 Oxford Way",
            "city": "Cocoa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329226445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Spencer Dickens
• Divine Accommodations in-Home Care Services LLC.
• Zykira Dixon
• Cassidy Lee Dobbins
• Meridith Dobbins
• Srinivas Rao Dontineni, MD
• Bethany Dowding, BS, BCABA
• Denise Pflaumer Downing, LMHC
• Cynthia Vicky Doyle, MA
• Jeannine Doyle, MPC

• Clinical Social Worker in Cocoa, FL
• Providers in Cocoa, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.