Domenica Doro

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.016997 Issued in IL

Practice address

475 W Terra Cotta Ave Ste E
Crystal Lake, IL 60014-3407

Phone

(815) 707-4806

NPI assigned

Dec 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

The Center for Courageous Living LLCGroup PAC ID 7113350612, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• The Center for Courageous Living LLC

  • Adult Mental Health Clinic/Center
  • Crystal Lake, IL
  • NPI 1457842460
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1194485722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 FORESTVIEW CT",
            "city": "CARPENTERSVILLE",
            "state": "IL",
            "postal_code": "601103378",
            "telephone_number": "920-366-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 W TERRA COTTA AVE STE E",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143407",
            "telephone_number": "815-707-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORO",
        "first_name": "DOMENICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-22",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.016997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly E Doerr, MS/CCC-SLP
• Edward G Dolezal, MD
• Maryann Dolezal, LCPC
• Michael Dollar
• Denise Marie Donovan, PT
• Kendra Dorschner, RBT
• Douglas N Neal & Associates LTD
• Brittney H Douglas
• Dr Paul a Bruggeman DDS PC
• Dr Raman Popli and Associates

• Professional Counselor in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.