Individual provider Active NPI

Dominique Williams

  • Professional Counselor
  • Pittsburgh, PA
National Provider Identifier
1255913588
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC015857 Issued in PA
Practice address
7605 Saltsburg Rd
Pittsburgh, PA 15239-1723
Phone
(724) 396-1510
Fax
(724) 972-4627
NPI assigned
Apr 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC015857 PA
Professional Counselor 101YP2500X PC015857 PA Primary

Addresses

Primary practice location

7605 Saltsburg Rd
Pittsburgh, PA 15239-1723

Mailing address

101 Pembroke CT
Greensburg, PA 15601-6404
Phone (724) 396-1510

Other practice location 1

325 N Highland Ave
Pittsburgh, PA 15206-2924
Phone (724) 396-1510

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dlwilliams@fccac.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20240206003653 PA Practitioner - Mental Health Counselor 7719320878 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC015857PAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Hoffman Professional CurrentSince Jan 19, 2024 Accepting new patients
Christian Counseling Associates of Western Pennsylvania Mental Health CurrentSince Jan 19, 2024 Accepting new patients

Locations

438 Pellis Rd
Ste 202
Greensburg, PA 15601
Phone (724) 832-7157

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1255913588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PEMBROKE CT",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156016404",
            "telephone_number": "724-396-1510",
            "fax_number": "724-972-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7605 SALTSBURG RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152391723",
            "telephone_number": "724-396-1510",
            "fax_number": "724-972-4627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 N Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152062924",
            "country_code": "US",
            "telephone_number": "724-396-1510",
            "fax_number": "724-972-4627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC015857",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC015857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dlwilliams@fccac.org",
            "affiliation": "N",
            "address_1": "321 Route 66",
            "city": "Leechburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "156568279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.