Individual provider Active NPI

Angelica Dominguez, LPC

  • Psychologist
  • El Paso, TX
National Provider Identifier
1386381523
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
40573 Issued in TX
Practice address
4615 Alameda Ave
El Paso, TX 79905-2702
Phone
(915) 215-5850
Fax
(915) 215-8657
NPI assigned
May 18, 2022
Last updated
Jul 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 80704 TX
Psychologist 103T00000X 40573 TX Primary

Addresses

Primary practice location

4615 Alameda Ave
El Paso, TX 79905-2702

Mailing address

13715 Cala Levane
San Antonio, TX 78253-5689

Other practice location 1

13715 Cala Levane
San Antonio, TX 78253-5689
Phone (915) 490-8446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250828002216 TX Practitioner - Clinical Psychologist 0446751895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4615 Alameda Ave
El Paso, TX 79905-2702
Phone (915) 215-5850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
80704TXMDProfessional Counselor
40573TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Psychologist CurrentSince Aug 1, 2025 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Aug 1, 2025 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients

Locations

4615 Alameda Ave
El Paso, TX 79905
Phone (432) 268-7247

Organizations & group practices 3

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": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1386381523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13715 CALA LEVANE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782535689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 ALAMEDA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052702",
            "telephone_number": "915-215-5850",
            "fax_number": "915-215-8657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13715 Cala Levane",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782535689",
            "country_code": "US",
            "telephone_number": "915-490-8446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "ANGELICA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "80704",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "40573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.