Dominique Lea Corellas

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

2396 NW Kings Blvd Ste 201
Corvallis, OR 97330-3984

Phone

(541) 224-1684

NPI assigned

May 27, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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.

• Westwind Counseling LLC

  • Clinical Social Worker
  • Corvallis, OR
  • NPI 1982199683
  NPD (past)

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1942823760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2396 NW KINGS BLVD STE 201",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303984",
            "telephone_number": "541-224-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2396 NW KINGS BLVD STE 201",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303984",
            "telephone_number": "541-224-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORELLAS",
        "first_name": "DOMINIQUE",
        "middle_name": "LEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan A Corcoran, FNP, CNM
• Jason Cordero
• Whitney Cordes
• Jennifer Cordova-Flores
• Core Vitality Clinic (Grace Good Health NW)
• Jacquelyn Corley, M.D.
• Abby Leigh Corliss, B.S.
• Elena Cornelius
• Lisa Ann Cornelius, DPM
• Reghan Cornell

• Clinical Social Worker in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.