DOMINIQUE CARRILLO
NPI 1174487482
Social Worker - Clinical in Tucson, AZ

Q: What is Dominique Carrillo's NPI number?

The NPI number for Dominique Carrillo is 1174487482. It was assigned to this individual provider in the NPPES registry on December 11, 2025.

Q: What is Dominique Carrillo's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since December 11, 2025PECOS EnrolledAccepts Medicare Assignment

2224 N CRAYCROFT RD STE 100, TUCSON, AZ 85712(520) 201-0730(520) 614-6050 Get Directions Write a Review

NPPES record last updated: December 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dominique Carrillo NPPES

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

DOMINIQUE CARRILLO (NPI 1174487482) is an individual clinical provider in Tucson, Arizona, licensed in Arizona (23475) and active in the NPI registry since December 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1174487482

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameDOMINIQUE CARRILLO

Location Address2224 N CRAYCROFT RD STE 100Tucson, AZ 85712-2811

Mailing Address2850 N Country Club RdTucson, AZ 85716-1910 · (520) 322-6274 · Fax (520) 509-4496

Phone(520) 201-0730

Fax(520) 614-6050

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateDecember 11, 2025

NPPES CertifiedDecember 11, 2025

✔ NPI 1174487482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in AZ · 23475

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

2224 N CRAYCROFT RD STE 100, Tucson, AZ 85712

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dominique Carrillo is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062908197

PECOS Enrollment IDI20251229001347

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85712 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $55.44 – $168.60

Typical copayment $0.00 (range $13.86 – $42.15)

Most-billed visit code NA

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. REYNELDA FELDER MAXWELL MA, CART, LPC

Counselor (Professional)