Domonic Vasquez, MHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0000000 Issued in MN

Practice address

2800 Freeway Blvd Ste 204
Minneapolis, MN 55430-1751

Phone

(763) 412-1996

Fax

(763) 292-5653

NPI assigned

Mar 23, 2021

Last updated

Mar 23, 2021By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kesma Flame Lily LLC

  • Professional Counselor
  • Brooklyn Center, MN
  • NPI 1295212355

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1114503711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 FREEWAY BLVD STE 204",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554301751",
            "telephone_number": "763-412-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 FREEWAY BLVD STE 204",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554301751",
            "telephone_number": "763-412-1996",
            "fax_number": "763-292-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "DOMONIC",
        "credential": "MHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "0000000",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "0000000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000000",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Minneapolis",
            "affiliation": "N",
            "endpointDescription": "Minnesota",
            "address_1": "2800 Freeway Blvd Ste 204",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554301751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vascular & Interventional Physicians
• Tanveer Vasdev
• Taylor Marie Vasek, RN
• Blair Vasilco
• Ciro Antonio Vasquez, M.D
• Kaitlin Vass, OD
• Karin A Vassar, NP
• Shashank Vats, MD
• John Forrest Vaubel
• Jessica Erin Vaughan-Jensen, PHD, LP

• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.