Individual provider Active NPI

Arnold Rafael Dominguez-Franco, RECOVERY SPECIALIST

  • Addiction (Substance Use Disorder) Counselor
  • Tewksbury, MA
National Provider Identifier
1538762059
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
SA1190566 Issued in MA
Practice address
365 East St Unit C-2
Tewksbury, MA 01876-1950
Phone
(857) 293-2005
NPI assigned
Nov 18, 2020
Last updated
Nov 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X SA1190566 MA Primary

Addresses

Primary practice location

365 East St Unit C-2
Tewksbury, MA 01876-1950

Mailing address

365 East St Unit C2
Tewksbury, MA 01876-1950
Phone (857) 293-2005

Other identifiers 1

IdentifierTypeStateIssuer
SA1190566MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SA1190566MAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1538762059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 EAST ST UNIT C2",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761950",
            "telephone_number": "857-293-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 EAST ST UNIT C-2",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761950",
            "telephone_number": "857-293-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ-FRANCO",
        "first_name": "ARNOLD",
        "middle_name": "RAFAEL",
        "credential": "RECOVERY SPECIALIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "SA1190566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA1190566",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.