Jacqueline Dominguez

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

10 Farragut Ave
Colorado Springs, CO 80909-5626

Phone

(719) 636-2122

NPI assigned

Feb 24, 2021

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

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.

• Carolina Center for Autism Services, LLC

  • Behavior Analyst
  • Durham, NC
  • NPI 1912069303

  Multi-Specialty

  NPD (past)
• The Carolina Center for ABA & Autism Treatment

  • Community/Behavioral Health Agency
  • Cary, NC
  • NPI 1184027252
  NPD (past)

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1992399489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MACKENAN DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275117903",
            "telephone_number": "919-371-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 FARRAGUT AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095626",
            "telephone_number": "719-636-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-24",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Richard Domer, PA-C
• Cara Malnati Domer, MSN, PMHNP
• Sidney Leroy Domier, RPH
• Clarissa Dominguez, RD
• Deizy Dominguez
• Patrice Dominguez
• Raquel Dominguez, MSW
• Victoria Dominguez
• Kimberly Sue Dominic, MA
• Kaitlyn Dominick

• Counselor in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.