Alli Domers, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

390 Reed Rd FL 1
Broomall, PA 19008-4008

Phone

(484) 450-6476

Fax

(484) 224-3398

NPI assigned

Sep 18, 2015

Last updated

Apr 6, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spectra Support Services, LLC

  • Clinical Social Worker
  • Broomall, PA
  • NPI 1134482409

  Behavior Analyst

  NPD

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1861861940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 REED RD FL 1",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190084008",
            "telephone_number": "484-450-6476",
            "fax_number": "484-224-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 REED RD FL 1",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190084008",
            "telephone_number": "484-450-6476",
            "fax_number": "484-224-3398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Lawrence Rd",
            "address_purpose": "LOCATION",
            "city": "Broomall",
            "state": "PA",
            "postal_code": "190083747",
            "country_code": "US",
            "telephone_number": "484-450-6476",
            "fax_number": "610-544-7142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMERS",
        "first_name": "ALLI",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-18",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divine Providence Village
• Divine Providence Village
• Dana Marie Dober, D.P.M.
• Phillip A Dobson, MD
• Rose Doe
• Margaret B Dooley, CRNP
• Leslie Robert Dorf, P.T.
• Zaira Doughty
• Dr Donald R Gordon & Associates
• Lauren Driscoll

• Clinical Social Worker in Broomall, PA
• Providers in Broomall, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; 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.