Hannah Domasky, LPC-IT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

620 W Brown St
Waupun, WI 53963-1702

Phone

(920) 324-5581

NPI assigned

May 19, 2021

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

Enrolled in WI

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rechek Psychotherapy Services, LLCGroup PAC ID 6305381914, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Rechek Psychotherapy Services LLC

  • Mental Health Counselor
  • Fond Du Lac, WI
  • NPI 1841030814
  Medicare reassignment Care Compare group NPD
• Agnesian Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fond Du Lac, WI
  • NPI 1841320884
  NPD (past)

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1447824982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W BROWN ST",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539631702",
            "telephone_number": "920-324-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W BROWN ST",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539631702",
            "telephone_number": "920-324-5581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMASKY",
        "first_name": "HANNAH",
        "credential": "LPC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamiah M Dekker, CRNA
• Gary L Dent, CRNA
• Ahmed Hassan Dessouki, M.D.
• Sheri Jane Dewar
• Robert Norman Deyoung, PHD
• Janette L Drews, NP
• Richard Frank Eckerstorfer, LCSW
• Lynn Edmunds, LAT
• Larry Edwards, R.PH.
• Amy Ewerdt, RD

• Professional Counselor in Waupun, WI
• Providers in Waupun, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.