Dominique Marcus, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW007261 Issued in GA

Practice address

691 John Wesley Dobbs Ave NE Ste V146
Atlanta, GA 30312-1690

Phone

(912) 430-7880

NPI assigned

Dec 16, 2020

Last updated

Dec 9, 2023By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Contemporary Healing Spaces, Inc

  • Clinical Social Worker
  • Atlanta, GA
  • NPI 1124784731
  NPD Authorized official

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702080000000",
    "number": "1346836061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 JOHN WESLEY DOBBS AVE NE STE V146",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121690",
            "telephone_number": "912-430-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 JOHN WESLEY DOBBS AVE NE STE V146",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121690",
            "telephone_number": "912-430-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "DOMINIQUE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2023-12-09",
        "certification_date": "2023-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088694",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Harrison Marcum, MD
• Marcus Autism Center
• Marcus Institute for Development and Learning Inc (Marcus Institute)
• Charles Marcus, MD
• David Joshua Marcus
• Robert Martin Marcus, M.D.
• Sally J Marcus
• Seth Benjamin Marcus, M.D.
• Allyson Marcy, PT, DPT, OCS
• Isaiah Gershon Marder, D.C.

• Clinical Social Worker in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2023; 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.