Domenique Harrison, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

138559 Issued in CA

Practice address

12851 Rubens Ave
Los Angeles, CA 90066-6539

Phone

(973) 477-4350

NPI assigned

May 9, 2021

Last updated

Oct 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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": "1620518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1609450311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12851 RUBENS AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666539",
            "telephone_number": "973-477-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12851 RUBENS AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900666539",
            "telephone_number": "973-477-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "DOMENIQUE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-09",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keniekha Shanice Harrison Hall
• Antonio Harrison, MA
• Caitlin Susanne Bancroft Harrison
• Cynthia Harrison, F.N.P, R.N.
• David Zachary Harrison, M.D.
• Heather Lucinda Harrison
• Jessica Lauren Harrison, RDN
• Jill Harrison, L.AC.
• Katrin Harrison, MSW
• Mingkuan Harrison

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.