Individual provider Active NPI

Domonique Rice, IMFT-S

  • Marriage & Family Therapist
  • Columbus, OH
National Provider Identifier
1790062321
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
F.1800041-SUPV Issued in OH
Practice address
1491 Polaris Pkwy Ste 216
Columbus, OH 43240-2041
Phone
(614) 568-1258
NPI assigned
Nov 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X M.1100005 OH
Marriage & Family Therapist 106H00000X 0717001625 VA
Marriage & Family Therapist 106H00000X F.1800041-SUPV OH Primary

Addresses

Primary practice location

1491 Polaris Pkwy Ste 216
Columbus, OH 43240-2041

Mailing address

1491 Polaris Pkwy Ste 216
Columbus, OH 43240-2041
Phone (614) 568-1258

Other identifiers 1

IdentifierTypeStateIssuer
1790062321MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Info@TheArtofLoveandIntimacy.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: No
  • 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
I20250603001125 OH Practitioner - Marriage and Family Therapist 6800313636 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
M.1100005OHMDMarriage & Family Therapist
0717001625VAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Marriage & Family Therapist Current Accepting new patients
Hope, Love, and Dream, Inc Marriage & Family Therapist CurrentSince May 15, 2020 Accepting new patients
Ohio Marriage and Family Therapy, LLC. Current Accepting new patients
Hope, Love, and Dream, Inc Marriage & Family Therapist CurrentSince Sep 8, 2024 Accepting new patients

Locations

1491 Polaris Pkwy
Columbus, OH 43240
Phone (614) 210-3815

670 Meridian Way
Ste 270
Westerville, OH 43082
Phone (614) 568-1258

Interoperability endpoints

  • Direct secure messaging: info@theartofloveandintimacy.com
  • Direct secure messaging: domoniquerice@tdh.allscriptsdirect.net

Organizations & group practices 4

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": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1790062321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1491 POLARIS PKWY STE 216",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432402041",
            "telephone_number": "614-568-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1491 POLARIS PKWY STE 216",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432402041",
            "telephone_number": "614-568-1258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICE",
        "first_name": "DOMONIQUE",
        "name_prefix": "Dr.",
        "credential": "IMFT-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-10",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "M.1100005",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001625",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "F.1800041-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790062321",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Info@TheArtofLoveandIntimacy.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1491 Polaris Pkwy Ste 216",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432402041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.