Dominique Atencio, BA
Individual provider Active NPI Case Manager/Care Coordinator · Lexington, KY
NPI 1447614342 · NPPES record last updated Apr 7, 2016
Key facts
- NPI
- 1447614342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 201 Mechanic St
Lexington, KY 40507-1086 - Phone
- (859) 272-7483
- Fax
- (859) 272-9685
- NPI assigned
- Apr 7, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
201 Mechanic St
Lexington, KY 40507-1086
Mailing address
201 Mechanic St
Lexington, KY 40507-1086
Phone (859) 272-7483
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790731081 | Medicaid | KY |
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All providers in Lexington, KY · Case Manager/Care Coordinator in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.