Individual provider Active NPI

Janine Domingues, PHD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1891184933
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
021024 Issued in NY
Practice address
445 Park Ave
New York, NY 10022-2606
Phone
(973) 224-1059
NPI assigned
Jan 13, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 021024 NY Primary

Addresses

Primary practice location

445 Park Ave
New York, NY 10022-2606

Mailing address

101 East 56TH Street
New York, NY 10022
Phone (646) 625-4277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
021024NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1891184933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 EAST 56TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "646-625-4277",
            "fax_number": "646-625-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222606",
            "telephone_number": "973-224-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUES",
        "first_name": "JANINE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.