NICOLE DOMINE LICSW
NPI 1396280954
Social Worker - Clinical in Fargo, ND
NPI Status: Active since January 05, 2017
Contact Information
4357 13TH AVE S STE 104
FARGO, ND
ZIP 58103
Phone: (701) 478-4480
Fax: (701) 478-4481
- Individual
- Female
- Social Worker
- Clinical
- Accepts Insurance
About NICOLE DOMINE
This page provides the complete NPI Profile along with additional information for Nicole Domine, a provider established in Fargo, North Dakota with a medical specialization in Social Worker, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1396280954 assigned on January 2017. The practitioner's primary taxonomy code is 1041C0700X with license number 5293 (ND). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1396280954
- Provider Name
- NICOLE DOMINE LICSW
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4357 13TH AVE S STE 104 FARGO, ND 58103
- Location Phone
- (701) 478-4480
- Location Fax
- (701) 478-4481
- Mailing Address
- 4357 13TH AVE S STE 104 FARGO, ND 58103
- Mailing Phone
- (701) 478-4480
- Mailing Fax
- (701) 478-4481
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-05-2017
- Last Update Date
- 11-22-2024
- Code Navigator
A clinical social worker like Nicole Domine is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Social Worker Clinical
- Taxonomy Code
- 1041C0700X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 5293
- License State
- ND
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | 23025 (MN) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCare Gold $25 PCP Copay ($5 Value Based Drug List) - PPO
- BlueCare Silver $45 PCP Copay ($5 Value Based Drug List) - PPO
- BlueDirect Bronze 100 HSA Eligible ($7500 Deductible / $5 Preventive Drug List) - PPO
- BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) - PPO
- BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) - PPO
- BlueEssential Catastrophic 100 $9200 Deductible - PPO
- BlueValue Bronze $50 PCP Copay (Standardized plan) - PPO
- BlueValue Gold $30 PCP Copay (Standardized plan) - PPO
- BlueValue Silver $40 PCP Copay (Standardized plan) - PPO
- DakotaBlue Altru Gold ($5 Value Based Drug List) - PPO
- DakotaBlue Altru Silver ($5 Value Based Drug List) - PPO
- DakotaBlue Trinity Gold ($5 Value Based Drug List) - PPO
- DakotaBlue Trinity Silver ($5 Value Based Drug List) - PPO
- Altru Prime by Medica Bronze $0 Copay PCP Visits - HMO
- Altru Prime by Medica Bronze Share - HMO
- Altru Prime by Medica Expanded Bronze Standard - HMO
- Altru Prime by Medica Gold $0 Copay PCP Visits - HMO
- Altru Prime by Medica Gold Share - HMO
- Altru Prime by Medica Gold Standard - HMO
- Altru Prime by Medica Silver $0 Copay PCP Visits - HMO
- Altru Prime by Medica Silver Share - HMO
- Altru Prime by Medica Silver Standard - HMO
- Essentia Choice Care with Medica Bronze $0 Copay PCP Visits - HMO
- Essentia Choice Care with Medica Bronze Share - HMO
- Essentia Choice Care with Medica Expanded Bronze Standard - HMO
- Essentia Choice Care with Medica Gold $0 Copay PCP Visits - HMO
- Essentia Choice Care with Medica Gold Share - HMO
- Essentia Choice Care with Medica Gold Standard - HMO
- Essentia Choice Care with Medica Silver $0 Copay PCP Visits - HMO
- Essentia Choice Care with Medica Silver Share - HMO
- Essentia Choice Care with Medica Silver Standard - HMO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze Share - HMO
- Sanford Individual Simplicity $1,750 - PPO
- Sanford Individual Simplicity $3,500 - PPO
- Sanford Individual Simplicity $4,750 - PPO
- Sanford Individual Simplicity $6,000 - PPO
- Sanford Individual Simplicity $7,100 HSA Qualified - PPO
- Sanford Individual Simplicity $9,200 - PPO
- Sanford Individual Simplicity Standardized $1,500 - PPO
- Sanford Individual Simplicity Standardized $5,000 - PPO
- Sanford Individual Simplicity Standardized $7,500 - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Reviews for NICOLE DOMINE LICSW
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 9 | 6 | 2 | 8 | 0 | 9 | 5 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 18 | 6 | 4 | 8 | 0 | 9 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 8 + 6 + 4 + 8 + 0 + 9 + 1 + 0 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1396280954 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
MRS. MIRACLE RAYE HOFF LPCC
Counselor
(Professional)
4357 13TH AVE S STE 104
FARGO, ND
ZIP 58103
INSIGHT BEHAVIORAL HEALTH PARTNERS
Clinic/Center
(Mental Health (Including Community Mental Health Center))
4357 13TH AVE S STE 104
FARGO, ND
ZIP 58103
MR. THOMAS KENNETH DUBBELS M.S., LPC
Counselor
(Mental Health)
4357 13TH AVE S STE 104
FARGO, ND
ZIP 58103
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396280954, enumerated as an "individual" on January 05, 2017.
The provider is located at 4357 13TH AVE S STE 104 FARGO, ND 58103 and the phone number is (701) 478-4480.
Social Worker with taxonomy code 1041C0700X and a focus in Clinical.
The provider might be accepting Accepts: Blue Cross Blue Shield of North Dakota, Medica and. Please consult your insurance carrier or call the provider to verify.
