Sara A. Dominicus, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC13265 Issued in ME

Practice address

778 Roosevelt TRL Ste 2B
Windham, ME 04062-5376

Phone

(207) 310-1230

NPI assigned

Aug 26, 2009

Last updated

Feb 11, 2025By 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 1

Addresses

Other names 1

• Sara Ann Richardson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sara Dominicus, LCSW PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Windham, ME
  • NPI 1407669120
  NPD Authorized official

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1447483243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 SHANNONS WAY",
            "city": "STANDISH",
            "state": "ME",
            "postal_code": "040845270",
            "telephone_number": "207-310-1230",
            "fax_number": "207-647-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "778 ROOSEVELT TRL STE 2B",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040625376",
            "telephone_number": "207-310-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINICUS",
        "first_name": "SARA",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC13265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "RICHARDSON",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sara Dayon, NP
• Lisa Defosse, LMT
• Katie Dickson, LADC, CCS, LCPC
• Dignity Home Care Services LLC
• Diversity Alliance LLC
• Julia Antonia Donaldson, LMT
• Stephen M Donnelly, DO
• Jenna Douglas, PHARM.D.
• Jennifer Dow
• Samantha Dow

• Clinical Social Worker in Windham, ME
• Providers in Windham, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.