Dominique Therese Maccurtin, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT39835 Issued in CA

Practice address

1200 D Street #7
Petaluma, CA 94952

Phone

(707) 343-5152

NPI assigned

Jan 17, 2007

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

Other names 1

• Dominique Therese Denardo Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

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.

• Cyti Health PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1679172290
  Medicare reassignment NPD

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1669524179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 D STREET #7",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94952",
            "telephone_number": "707-343-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 D STREET #7",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94952",
            "telephone_number": "707-343-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCURTIN",
        "first_name": "DOMINIQUE",
        "middle_name": "THERESE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT39835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOMINIQUE",
            "last_name": "DENARDO",
            "middle_name": "THERESE",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Faye Susan Lundergan, MD
• Teresa Lynn Lurie, NP
• Luxottica of America Inc.
• Laura Lyons, AMFT
• Roxanne Macaraeg
• Alexandra Anna Samantha Mach
• Leeanna Rochelle Bishop Machado
• Silvio Machado, PSYCHOLOGIST
• Darlene Machuca Grande
• Valeria Macias

• Marriage & Family Therapist in Petaluma, CA
• Providers in Petaluma, 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 Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.