Dominique Walker, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

009175 Issued in NY

Practice address

631 Montauk Hwy Ste 7
West Islip, NY 11795-4400

Phone

(631) 835-9886

NPI assigned

Jun 5, 2012

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": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1710248950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 MONTAUK HWY STE 7",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954400",
            "telephone_number": "631-835-9886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 MONTAUK HWY STE 7",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954400",
            "telephone_number": "631-835-9886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13 Temple St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "MA",
            "postal_code": "021695110",
            "country_code": "US",
            "telephone_number": "781-556-5172 x32",
            "fax_number": "781-749-3873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "DOMINIQUE",
        "name_prefix": "Miss",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "009175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in West Islip, NY
• Providers in West Islip, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.