Individual provider Active NPI

Dominique Taylor Muren

  • Mental Health Counselor
  • Mastic, NY
National Provider Identifier
1346682580
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
NY-006895 Issued in NY
Practice address
1235 Montauk Hwy
Mastic, NY 11950-2917
Phone
(631) 456-2979
NPI assigned
Jul 29, 2013
Last updated
Jan 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NY-006895 NY Primary

Addresses

Primary practice location

1235 Montauk Hwy
Mastic, NY 11950-2917

Mailing address

1235 Montauk Hwy
Mastic, NY 11950-2917
Phone (631) 456-2979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250620003182 NY Practitioner - Mental Health Counselor 3678085198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tina Flanagan Licensed Mental Health Counselor P.C.Group PAC ID 7315489663, 2 clinicians

Practice addresses (Care Compare)

1777 Veterans Memorial Hwy
Suite 14
Islandia, NY 11749-1555
Phone (631) 630-6439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NY-006895NYMDMental Health Counselor
006895NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tina Flanagan Licensed Mental Health Counselor P.C. CurrentSince Apr 17, 2025 Accepting new patients

Locations

1777 Veterans Memorial Hwy
Ste 14
Islandia, NY 11749
Phone (631) 212-2405

94 Medford Ave
Patchogue, NY 11772
Phone (631) 213-9882

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1346682580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 MONTAUK HWY",
            "city": "MASTIC",
            "state": "NY",
            "postal_code": "119502917",
            "telephone_number": "631-456-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 MONTAUK HWY",
            "city": "MASTIC",
            "state": "NY",
            "postal_code": "119502917",
            "telephone_number": "631-456-2979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUREN",
        "first_name": "DOMINIQUE",
        "middle_name": "TAYLOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "NY-006895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mastic, NY

Sources for this page

Verify at the official NPI Registry.