Individual provider Active NPI

Yesenia Dominguez Pereira, LCSW

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1265243695
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
107967 Issued in TX
Practice address
539 W Commerce St Ste 2505
Dallas, TX 75208-1953
Phone
(972) 850-7901
NPI assigned
Jan 15, 2025
Last updated
Jan 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 107967 TX Primary

Addresses

Primary practice location

539 W Commerce St Ste 2505
Dallas, TX 75208-1953

Mailing address

4302 Hartford St
Dallas, TX 75219-2626
Phone (214) 529-3248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
107967TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1265243695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 HARTFORD ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192626",
            "telephone_number": "214-529-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 W COMMERCE ST STE 2505",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752081953",
            "telephone_number": "972-850-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ PEREIRA",
        "first_name": "YESENIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "107967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.