Andrea Lynn Dominick, LPCC-S, LICDC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.0600629 SUPV Issued in OH

Practice address

205 Hospital Dr
Dover, OH 44622-2058

Phone

(330) 343-7950

NPI assigned

Feb 28, 2007

Last updated

May 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coleman Professional Services, Inc.Group PAC ID 2769474618, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HDGCDA

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.

• Coleman Professional Services, Inc.

  • Mental Health Counselor
  • Kent, OH
  • NPI 1982637633
  Medicare reassignment Care Compare group NPD
• Springvale Health Centers, Inc

  • Mental Health Counselor
  • Dover, OH
  • NPI 1477508406
  Medicare reassignment NPD
• Springvale Health Centers,Inc

  • Federally Qualified Health Center (FQHC)
  • Dover, OH
  • NPI 1396577276
  NPD

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1235266743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 BOULEVARD ST",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222026",
            "telephone_number": "330-343-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DR",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222058",
            "telephone_number": "330-343-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINICK",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "LPCC-S, LICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "111001",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0600629 SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Denham
• Zachary Ryan Denham, MD
• Timothy Paul Desiato, M.D.
• Stephanie Marie Dickerson
• Discount Drug Mart Inc (Discount Drug Mart)
• Brittany Jane Douglas
• Sara Ashley Douglas
• Dover City Schools
• Dover Orthopaedic Center, Inc
• Dowell Dental Holdings Dover LLC (Dowell Dental Group)

• Mental Health Counselor in Dover, OH
• Providers in Dover, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.