JESSICA DOMKE LPC, ATR
NPI 1083575989
Counselor - Mental Health in Bridgeton, MO
About Jessica Domke Lpc, Atr NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSICA DOMKE LPC, ATR (NPI 1083575989) is an individual mental health provider in Bridgeton, Missouri, licensed in Missouri (2022037793) and active in the NPI registry since November 2025. She has opted out of Medicare through April 22, 2028.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Jessica Domke Lpc, Atr has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 22, 2026 through April 22, 2028.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jessica Domke's NPI number?
The NPI number for Jessica Domke is 1083575989. It was assigned to this individual provider in the NPPES registry on November 20, 2025.
Where is Jessica Domke located?
Jessica Domke practices at 12143 Old Saint Charles Rd, Bridgeton, MO 63044. The listed phone number is (314) 656-6113.
What is Jessica Domke's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Jessica Domke enrolled in Medicare?
No. Jessica Domke has opted out of Medicare through April 22, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Jessica Domke was last updated on November 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jessica Domke, LPC, ATR · NPI 1083575989
Mental Health provider in Bridgeton, Missouri. Individual provider, active in the CMS NPPES registry since November 20, 2025.
## Identity
- **NPI:** 1083575989 (Entity type: Individual)
- **Enumerated:** November 20, 2025
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 2022037793 (Missouri)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 12143 OLD SAINT CHARLES RD, Bridgeton, MO 63044-2816
- **Phone:** (314) 656-6113
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through April 22, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** November 20, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1083575989) · Data from the CMS NPPES public registry.