Kelly Rae Dominici, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1601 E Fourth Plain Blvd # V3-Satp
Vancouver, WA 98661-3753

Phone

(503) 237-5296

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1841386059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3818 N PIONEER CANYON DR",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986428288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E FOURTH PLAIN BLVD # V3-SATP",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613753",
            "telephone_number": "503-237-5296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINICI",
        "first_name": "KELLY",
        "middle_name": "RAE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Connor Domek, DPT
• Anthony Joseph Domenigoni, D.P.M.
• Ashley J Domingo, RN
• Cecilia M Dominguez, PSY.D
• Karina Dominguez
• Ruth E Don, LMP
• Todd Allen Dona, RN
• Geni Donaghey, M.S.-CCC/SLP
• Donald Benz MD PLLC
• Jill Donald

• Social Worker in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.