Jessica Elizabeth Domingo

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW17888 Issued in FL

Practice address

156 Tollgate TRL
Longwood, FL 32750-3855

Phone

(407) 920-5270

NPI assigned

Mar 15, 2023

Last updated

Jun 26, 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

Enrolled in FL, MA, TX, VT, VA5 enrollments

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 5

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  FL, MA, TX, VT

  Medicare reassignment Care Compare group NPD
• Sunflower Therapy LLC

  • Clinical Social Worker
  • Pittsfield, MA
  • NPI 1316770993
  Medicare reassignment NPD Authorized official
• Sunflower Therapy LLC

  dba Sunflower Therapy

  • Clinical Social Worker
  • Richmond, VA
  • NPI 1215823752
  Medicare reassignment NPD (past) Authorized official
• Brave Health Inc.

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1821588674
  Medicare reassignment NPD
• Sunflower Therapy LLC

  • Clinical Social Worker
  • Casselberry, FL
  • NPI 1588409189
  NPD (past) Authorized official
• Sunflower Therapy LLC

  • Clinical Social Worker
  • Spokane, WA
  • NPI 1013821560
  Authorized official Same address or phone
• Sunflower Therapy LLC

  • Clinical Social Worker
  • York, ME
  • NPI 1114870623
  NPD (past) Authorized official
• Sunflower Therapy LLC

  • Clinical Social Worker
  • Austin, TX
  • NPI 1265318844
  NPD (past) Authorized official
• Sunflower Therapy LLC

  • Clinical Social Worker
  • Shelburne, VT
  • NPI 1689559957
  NPD (past) Authorized official

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1699476713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 TOLLGATE TRL",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503855",
            "telephone_number": "407-920-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 TOLLGATE TRL",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503855",
            "telephone_number": "407-920-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mandana Alborzfard Dixon, ARNP
• Dlka Holdings, LLC
• Jade Dobynes, RBT
• Hanna Rose Dohm
• Narchele Doleyres
• David Edward Donald, D.D.S.
• Melissa Joan Donnelly, ED.S., BCBA
• Yolene Dorga, ARNP
• Nirali Doshi Lapierre, LMHC
• Kayle Brooke Dossett

• Clinical Social Worker in Longwood, FL
• Providers in Longwood, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.