Christopher Rae Dominguez, M.S. , AMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

13760061-3904 Issued in UT

Practice address

10718 S Beckstead LN Ste 103
South Jordan, UT 84095-2605

Phone

(801) 477-0041

NPI assigned

Jan 15, 2024

Last updated

Jun 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Marriage and Family Therapist

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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.

• Arcadia Counseling LLC

  • Marriage & Family Therapist
  • Lehi, UT
  • NPI 1801478664
  Medicare reassignment NPD
• Northern Utah Center for Couples and Families

  dba Provo Center for Couples and Families

  • Clinic/Center
  • Orem, UT
  • NPI 1417299827
  NPD (past)

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1881465177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 E 820 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840975481",
            "telephone_number": "801-477-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10718 S BECKSTEAD LN STE 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840952605",
            "telephone_number": "801-477-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "CHRISTOPHER",
        "middle_name": "RAE",
        "name_prefix": "Mr.",
        "credential": "M.S. , AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "13760061-3904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kindee Dixon, LCMHC
• Tanner Dixon
• Chance Doan I
• Donnovan Dolato, ATC, CSCS, NSCA-CPT
• Mattison Doman
• James R Donahoo, DDS
• Donald R Call Jr DPM LLC
• Chelsea Doucet, LMSW, CSW
• Douglas S. Mehr, M.D., P.C. (Salt Lake Retina)
• Draper Dermatology, P.C.

• Marriage & Family Therapist in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Marriage & Family Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.