Jenna Michele Domingo, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00853000 Issued in NJ

Practice address

312 Amboy Ave Ste 2
Metuchen, NJ 08840-2455

Phone

(732) 902-2181

NPI assigned

Nov 6, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jenna Michele D'Amelio Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Integrative Therapy Institute New Jersey

  • Clinical Psychologist
  • Metuchen, NJ
  • NPI 1033509401

  Professional

  NPD

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

{
    "created_epoch": "1636156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1457016297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 AMBOY AVE STE 2",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 AMBOY AVE STE 2",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402455",
            "telephone_number": "732-902-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "JENNA",
        "middle_name": "MICHELE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-06",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00853000",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "D'AMELIO",
            "middle_name": "MICHELE",
            "credential": "LAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ingrid Diaz, PHD
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• Alexa Dimeglio, LCSW
• Rosalie Theresa-Ann Disimone-Weiss, PH.D.
• Patricia Dobrowski, PT, DPT
• Nicolle Violet Donato, DMD
• Robert E Donohue, PHD
• Dr. Kevin Vieser LLC
• Taniyah Lynnae Dubose
• Peter M Duch, M.D.

• Professional Counselor in Metuchen, NJ
• Providers in Metuchen, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.