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KETTY DOMINGUEZ LMHC
NPI 1144855636
Counselor - Mental Health in Palm Beach Gardens, FL

Active since March 05, 2020Opted out of Medicare · through Oct 25, 2026
4580 PGA BLVD STE 205, PALM BEACH GARDENS, FL 33418(561) 352-6936 Get Directions Write a Review

NPPES record last updated: October 24, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ketty Dominguez Lmhc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KETTY DOMINGUEZ LMHC (NPI 1144855636) is an individual mental health provider in Palm Beach Gardens, Florida, licensed in Florida (MH17812) and active in the NPI registry since March 2020. She has opted out of Medicare through October 25, 2026.

NPPES Registry Identity

NPI1144855636
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKETTY DOMINGUEZCredential: LMHC
Location Address4580 PGA BLVD STE 205Palm Beach Gardens, FL 33418-3920
Mailing Address1743 Newhaven Point LnWest Palm Beach, FL 33411-6609 · (561) 352-6936
Phone(561) 352-6936
Sole ProprietorNo
Enumeration DateMarch 5, 2020
Last NPPES UpdateOctober 24, 2024
NPPES CertifiedOctober 24, 2024
✔ NPI 1144855636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in FL · MH17812
4580 PGA BLVD STE 205, Palm Beach Gardens, FL 33418
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ketty Dominguez Lmhc 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 October 25, 2024 through October 25, 2026.

Opt-Out Effective DateOctober 25, 2024
Opt-Out In Effect ThroughOctober 25, 2026Opt-out affidavits renew automatically every two years unless cancelled

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 Ketty Dominguez's NPI number?

The NPI number for Ketty Dominguez is 1144855636. It was assigned to this individual provider in the NPPES registry on March 5, 2020.

Where is Ketty Dominguez located?

Ketty Dominguez practices at 4580 Pga Blvd Ste 205, Palm Beach Gardens, FL 33418. The listed phone number is (561) 352-6936.

What is Ketty Dominguez's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Ketty Dominguez enrolled in Medicare?

No. Ketty Dominguez has opted out of Medicare through October 25, 2026. 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 Ketty Dominguez was last updated on October 24, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.