Individual provider Active NPI

Lori Reeve-Domeny, PH.D.

  • Clinical Psychologist
  • Port Washington, NY
National Provider Identifier
1780636654
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
012172 Issued in NY
Practice address
1440 Port Washington Blvd
Port Washington, NY 11050-2412
Phone
(516) 719-9400
Fax
(516) 944-8518
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 012172 NY Primary

Addresses

Primary practice location

1440 Port Washington Blvd
Port Washington, NY 11050-2412

Mailing address

1 Old Country Rd
Suite 271
Carle Place, NY 11514-1801
Phone (800) 725-6280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040507001296 NY Practitioner - Clinical Psychologist 4880683572 Practice locations: New Hyde Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

701 Lowell Ave
New Hyde Park, NY 11040-3009
Phone (516) 616-1607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Life Management, P.L.L.C. 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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780636654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OLD COUNTRY RD",
            "address_2": "SUITE 271",
            "city": "CARLE PLACE",
            "state": "NY",
            "postal_code": "115141801",
            "telephone_number": "800-725-6280",
            "fax_number": "800-725-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 PORT WASHINGTON BLVD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110502412",
            "telephone_number": "516-719-9400",
            "fax_number": "516-944-8518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVE-DOMENY",
        "first_name": "LORI",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

Verify at the official NPI Registry.