Dominique Myrick

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

528 Dry Run Rd
Portsmouth, OH 45663-8988

Phone

(614) 980-2116

NPI assigned

Jan 24, 2019

Sex

Male

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

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

• Directly Affected

  • Adolescent and Children Mental Health Clinic/Center
  • Mesa, AZ
  • NPI 1124603394

  Single Specialty

  NPD Authorized official
• A Great Work Ministries Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Portsmouth, OH
  • NPI 1538623368
  NPD (past) Authorized official

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668297600000",
    "number": "1922562909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 184",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456620184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 DRY RUN RD",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456638988",
            "telephone_number": "614-980-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYRICK",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-24",
        "last_updated": "2022-11-13",
        "certification_date": "2022-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Musick
• Kaylyn Sue Musser, LPN
• Samantha Musser
• Angela L Myers, CDCA
• Ashlee Myers
• Dhashaini Nadarajah, M.D.
• Mary Nagel
• Miranda Nagel
• Ann Marie Nagle, LPN
• Tarun R. Nagrani, MD

• Professional Counselor in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.