Active NPI
Glenda Raquel Perez Dominguez, LCDA.
- Counselor
- Cabo Rojo, PR
National Provider Identifier
1316739360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 4514
- Practice address
- 117 Calle Bahia
Cabo Rojo, PR 00623-8942 - Phone
- (787) 642-2581
- NPI assigned
- May 17, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Counselor | 101Y00000X | 4514 | PR | Primary |
| Pastoral Counselor | 101YP1600X | |||
| Professional Counselor | 101YP2500X | |||
| School Counselor | 101YS0200X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X |
Addresses
Primary practice location
117 Calle Bahia
Cabo Rojo, PR 00623-8942
Mailing address
117 Calle Bahia
Cabo Rojo, PR 00623-8942
Phone (787) 642-2581
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4514 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747440000000",
"number": "1316739360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 CALLE BAHIA",
"city": "CABO ROJO",
"state": "PR",
"postal_code": "006238942",
"telephone_number": "787-642-2581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 CALLE BAHIA",
"city": "CABO ROJO",
"state": "PR",
"postal_code": "006238942",
"telephone_number": "787-642-2581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ DOMINGUEZ",
"first_name": "GLENDA",
"middle_name": "RAQUEL",
"credential": "LCDA.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-17",
"last_updated": "2025-05-17",
"certification_date": "2025-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "PR",
"license": "4514",
"primary": true
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cabo Rojo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.