Kelly Dominic, Imft LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

KELLY DOMINIC, IMFT LLC

Practice address

10955 Clearport Rd SW
Amanda, OH 43102-9612

Phone

(330) 730-9511

Fax

(614) 437-2580

NPI assigned

Mar 16, 2023

Last updated

Oct 28, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly M Dominic, LMFT-SNPI 1073007985

Title

Marriage and Family Therapist Owner

Phone

(330) 730-9511

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelly M Dominic, LMFT-S

  • Marriage & Family Therapist
  • Lancaster, OH
  • NPI 1073007985
  NPD Authorized official

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

{
    "created_epoch": "1678924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793145600000",
    "number": "1811698657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10955 CLEARPORT RD SW",
            "city": "AMANDA",
            "state": "OH",
            "postal_code": "431029612",
            "telephone_number": "330-730-9511",
            "fax_number": "614-437-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10955 CLEARPORT RD SW",
            "city": "AMANDA",
            "state": "OH",
            "postal_code": "431029612",
            "telephone_number": "330-730-9511",
            "fax_number": "614-437-2580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "408 N Columbus St",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "OH",
            "postal_code": "431303033",
            "country_code": "US",
            "telephone_number": "740-206-8659",
            "fax_number": "614-437-2580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KELLY DOMINIC, IMFT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-16",
        "last_updated": "2026-10-28",
        "certification_date": "2026-10-28",
        "status": "A",
        "authorized_official_last_name": "DOMINIC",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MARRIAGE AND FAMILY THERAPIST OWNER",
        "authorized_official_telephone_number": "330-730-9511",
        "authorized_official_credential": "LMFT-S"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shelly B Russ, LPN
• S&Q Solutions

• Marriage & Family Therapist in Amanda, OH
• Providers in Amanda, OH by specialty
• Marriage & Family Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.

Verify at the official NPI Registry.