MR. RICHARD JOHN DOMENICO LICSW
NPI 1306915061
Social Worker - Clinical in Boston, MA

Active since November 07, 2006Opted out of Medicare · through Feb 10, 2027
607 BOYLSTON ST FL 2, BOSTON, MA 02116(617) 266-2266(617) 266-6070 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Richard John Domenico Licsw NPPES

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

MR. RICHARD JOHN DOMENICO LICSW (NPI 1306915061) is an individual clinical provider in Boston, Massachusetts, licensed in Massachusetts (1027486) and active in the NPI registry since November 2006. He has opted out of Medicare through February 10, 2027.

NPPES Registry Identity

NPI1306915061
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. RICHARD JOHN DOMENICOCredential: LICSW
Location Address607 BOYLSTON ST FL 2Boston, MA 02116-3604
Mailing Address607 Boylston St Fl 2Boston, MA 02116-3604 · (617) 266-2266 · Fax (617) 266-6070
Fax(617) 266-6070
Sole ProprietorYes
Enumeration DateNovember 7, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1306915061 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 MA · 1027486
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.
607 BOYLSTON ST FL 2, Boston, MA 02116

Other Identifiers 2

Medicare ID-Type UnspecifiedP22595MA
OtherP07285MA · Bcbs

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Mr. Richard John Domenico Licsw 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 February 10, 2021 through February 10, 2027.

Opt-Out Effective DateFebruary 10, 2021
Opt-Out In Effect ThroughFebruary 10, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 2

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

Psychologist (Clinical)
607 BOYLSTON ST FL 2, RASI ASSOCIATES
BOSTON, MA 02116
Counselor (Mental Health)
607 BOYLSTON ST FL 2
BOSTON, MA 02116

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 Richard Domenico's NPI number?

The NPI number for Richard Domenico is 1306915061. It was assigned to this individual provider in the NPPES registry on November 7, 2006.

Where is Richard Domenico located?

Richard Domenico practices at 607 Boylston St Fl 2, Boston, MA 02116. The listed phone number is (617) 266-2266.

What is Richard Domenico's specialty?

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

Is Richard Domenico enrolled in Medicare?

No. Richard Domenico has opted out of Medicare through February 10, 2027. 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 Richard Domenico was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.