Individual provider Active NPI

Dominique Harris, LCSW

  • Mental Health Counselor
  • Colorado Springs, CO
National Provider Identifier
1780158071
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CSW.09927093 Issued in CO
Practice address
10312 Horton Dr
Colorado Springs, CO 80925-1473
Phone
(703) 498-7761
NPI assigned
Jan 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LSW.0009922120 CO
Mental Health Counselor 101YM0800X CSW.09927093 CO Primary

Addresses

Primary practice location

10312 Horton Dr
Colorado Springs, CO 80925-1473

Mailing address

10312 Horton Dr
Colorado Springs, CO 80925-1473
Phone (703) 498-7761

Other practice location 1

7430 Vineland Trl
Colorado Springs, CO 80911-9626
Phone (703) 498-7761

Other practice location 2

1724 N Gilpin St
Denver, CO 80218-1206
Phone (720) 441-3398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09927093COMDMental Health Counselor
LSW.0009922120COMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1547856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1780158071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10312 HORTON DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809251473",
            "telephone_number": "703-498-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10312 HORTON DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809251473",
            "telephone_number": "703-498-7761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7430 Vineland Trl",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809119626",
            "country_code": "US",
            "telephone_number": "703-498-7761",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1724 N Gilpin St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802181206",
            "country_code": "US",
            "telephone_number": "720-441-3398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "DOMINIQUE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-19",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LSW.0009922120",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "CSW.09927093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.