Individual provider Active NPI

Dominique Nerestan, LCSW

  • Clinical Social Worker
  • Carmel, NY
National Provider Identifier
1467646059
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
063179 Issued in NY
Practice address
667 Stoneleigh Ave Ste 202
Carmel, NY 10512-2455
Phone
(845) 279-5908
NPI assigned
Aug 28, 2007
Last updated
May 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 063179 NY Primary

Addresses

Primary practice location

667 Stoneleigh Ave Ste 202
Carmel, NY 10512-2455

Mailing address

667 Stoneleigh Ave Ste 202
Carmel, NY 10512-2455

Other practice location 1

50 Main St
White Plains, NY 10606-1901
Phone (718) 708-5655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20080421000374 NY Practitioner - Clinical Social Worker 7416035175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carmel Psychological Health PCGroup PAC ID 4385530351, 222 clinicians

Practice addresses (Care Compare)

667 Stoneleigh Ave
Suite 202
Carmel, NY 10512-2455
Phone (845) 279-5908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
063179NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical, Consultation and Supervision Services LCSW PLLC Clinical CurrentSince May 5, 2022 Accepting new patients
Carmel Psychological Health, PC Clinical CurrentSince Jan 26, 2026 Accepting new patients

Locations

3510 Bainbridge Ave
Apt S1
Bronx, NY 10467
Phone (718) 655-5552

667 Stoneleigh Ave
Ste 202
Carmel, NY 10512
Phone (845) 278-5223

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1467646059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 STONELEIGH AVE STE 202",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105122455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 STONELEIGH AVE STE 202",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105122455",
            "telephone_number": "845-279-5908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Main St",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106061901",
            "country_code": "US",
            "telephone_number": "718-708-5655",
            "fax_number": "888-812-4062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NERESTAN",
        "first_name": "DOMINIQUE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "063179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, NY

Sources for this page

Verify at the official NPI Registry.