Individual provider Active NPI

Jeanette Dominguez, LPC

  • Professional Counselor
  • Dallas, TX
National Provider Identifier
1699212902
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
73222 Issued in TX
Practice address
5565 Preston Oaks Rd Apt 106
Dallas, TX 75254-8425
Phone
(915) 217-8092
NPI assigned
Jan 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 73222 TX Primary

Addresses

Primary practice location

5565 Preston Oaks Rd Apt 106
Dallas, TX 75254-8425

Mailing address

5565 Preston Oaks Rd Apt 106
Dallas, TX 75254-8425
Phone (915) 217-8092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240226001954 TX Practitioner - Mental Health Counselor 6002251444 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District CurrentSince Jan 13, 2024 Accepting new patients
Dallas County Hospital District CurrentSince Jan 13, 2024 Accepting new patients
Dallas County Hospital District Current Accepting new patients

Locations

801 Conover Dr
Grand Prairie, TX 75051
Phone (214) 266-3400

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1699212902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 PRESTON OAKS RD APT 106",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548425",
            "telephone_number": "915-217-8092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 PRESTON OAKS RD APT 106",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548425",
            "telephone_number": "915-217-8092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "JEANETTE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "73222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.