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MARY ANN DOM LPC
NPI 1356507586
Counselor - Professional in Leon Valley, TX

Active since August 07, 2008PECOS Enrolled
6502 BANDERA RD STE 202, LEON VALLEY, TX 78238(210) 488-0384(210) 941-0682 Get Directions Write a Review

NPPES record last updated: June 23, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mary Ann Dom Lpc NPPES

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

MARY ANN DOM LPC (NPI 1356507586) is an individual professional provider in Leon Valley, Texas, licensed in Texas (12359) and active in the NPI registry since August 2008. She is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1356507586
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMARY ANN DOMCredential: LPC
Location Address6502 BANDERA RD STE 202Leon Valley, TX 78238-1454
Mailing Address2186 Jackson Keller Rd Ste 2134San Antonio, TX 78213-2723 · (210) 488-0384 · Fax (210) 941-0684
Phone(210) 488-0384
Fax(210) 941-0682
Sole ProprietorYes
Medical School CMSOtherGraduated 1991
Enumeration DateAugust 7, 2008
Last NPPES UpdateJune 23, 2026
NPPES CertifiedJune 23, 2026
✔ NPI 1356507586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in TX · 12359
Also ListedCounselorTaxonomy 101Y00000X · License 12359 (TX)
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 12359 (TX)
6502 BANDERA RD STE 202, Leon Valley, TX 78238
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Cigna Healthcare, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Ann Dom Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7517438419
PECOS Enrollment IDI20260602000543
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.

Medicare Billing Reassignment

Medicare enrollment records show Mary Dom reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PA
1,157 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Texas enrollment
  • 1,573 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Mary Dom's NPI number?

The NPI number for Mary Dom is 1356507586. It was assigned to this individual provider in the NPPES registry on August 7, 2008.

Where is Mary Dom located?

Mary Dom practices at 6502 Bandera Rd Ste 202, Leon Valley, TX 78238. The listed phone number is (210) 488-0384.

What is Mary Dom's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Mary Dom enrolled in Medicare?

Yes. Mary Dom is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Dom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Dom reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Dom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mary Dom accept?

Health plans from Blue Cross and Blue Shield of Texas, Cigna Healthcare, Oscar Insurance Company and UnitedHealthcare list Mary Dom as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Dom was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.