Individual provider Active NPI

Dominique Krystal Parker

  • Addiction (Substance Use Disorder) Counselor
  • New York, NY
National Provider Identifier
1427938521
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
928 Broadway Ste 403
New York, NY 10010-8151
Phone
(212) 481-1055
NPI assigned
Sep 8, 2025
Last updated
Oct 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X NY Primary

Addresses

Primary practice location

928 Broadway Ste 403
New York, NY 10010-8151

Mailing address

928 Broadway Ste 403
New York, NY 10010-8151
Phone (212) 481-1055

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bliss-Poston the Second Wind, Inc. Single Specialty CurrentSince Sep 14, 2025 Accepting new patients
Ambitious Soule L.L.C Current Accepting new patients

Locations

928 Broadway
Ste 403
New York, NY 10010
Phone (212) 481-1055

Organizations & group practices 2

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": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1427938521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 BROADWAY STE 403",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100108151",
            "telephone_number": "212-481-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 BROADWAY STE 403",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100108151",
            "telephone_number": "212-481-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "DOMINIQUE",
        "middle_name": "KRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.