Active NPI
Dominic Lerose, APSW
- Clinical Social Worker
- Madison, WI
National Provider Identifier
1780500694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 136132121
- Practice address
- 3101 Latham Dr
Madison, WI 53713-4613 - Phone
- (608) 286-1132
- NPI assigned
- Jun 25, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 136132121 | WI | Primary |
Addresses
Primary practice location
3101 Latham Dr
Madison, WI 53713-4613
Mailing address
2 W Gorham St Apt G1
Madison, WI 53703-2087
Phone (847) 830-2144
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Cognition, LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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": "1782345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782345600000",
"number": "1780500694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 W GORHAM ST APT G1",
"city": "MADISON",
"state": "WI",
"postal_code": "537032087",
"telephone_number": "847-830-2144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 LATHAM DR",
"city": "MADISON",
"state": "WI",
"postal_code": "537134613",
"telephone_number": "608-286-1132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEROSE",
"first_name": "DOMINIC",
"credential": "APSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-06-25",
"last_updated": "2026-06-25",
"certification_date": "2026-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "136132121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.