Nicole Elizabeth Domachowski, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2021014350 Issued in MO

Practice address

12110 Clayton Rd
Saint Louis, MO 63131-2516

Phone

(314) 989-6150

NPI assigned

May 12, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1508440801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312516",
            "telephone_number": "314-989-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312516",
            "telephone_number": "314-989-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMACHOWSKI",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2021014350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Dollenmeyer, MPT, MSCS
• Cortney Dollens, LPC
• Karen L Dolnick, ANP
• Hailey Dolphin
• Jon M Domachowski, M.A., PLPC
• John Joseph Dombrowski, MD, PHD
• Michael McKinley Dombrowski, MD
• Rachel Domingos, MD
• Carolina Maite Dominguez
• Jessica Sanjana Dominic, MD

• Behavior Analyst in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.