MRS. JESSICA CATHERINE DOMINGUEZ LCSW
NPI 1407176209
Social Worker - Clinical in Smithtown, NY

Active since June 03, 2010PECOS Enrolled
11 ROUTE 111, SMITHTOWN, NY 11787(631) 920-8300(631) 920-8460 Get Directions Write a Review

NPPES record last updated: August 20, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mrs. Jessica Catherine Dominguez Lcsw NPPES

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

MRS. JESSICA CATHERINE DOMINGUEZ LCSW (NPI 1407176209) is an individual clinical provider in Smithtown, New York, licensed in New York (082105) and active in the NPI registry since June 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2009).

NPPES Registry Identity

NPI1407176209
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. JESSICA CATHERINE DOMINGUEZCredential: LCSW
Location Address11 ROUTE 111Smithtown, NY 11787-3712
Mailing Address11 Route 111Smithtown, NY 11787-3712 · (631) 920-8300 · Fax (631) 920-8460
Fax(631) 920-8460
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateJune 3, 2010
Last NPPES UpdateAugust 20, 2015
NPI 1407176209 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in NY · 082105
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.

Also ListedSocial WorkerTaxonomy 104100000X · License 080537-1 (NY)
11 ROUTE 111, Smithtown, NY 11787

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Mrs. Jessica Catherine Dominguez Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3072733120
PECOS Enrollment IDI20141013001672
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 11787 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 $67.40 – $203.53
Typical copayment $0.00 (range $16.85 – $50.88)
Most-billed visit code NA
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
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 20

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

Social Worker (Clinical)
11 ROUTE 111
SMITHTOWN, NY 11787
Social Worker (Clinical)
11 ROUTE 111
SMITHTOWN, NY 11787
Social Worker (Clinical)
11 ROUTE 111
SMITHTOWN, NY 11787
Psychiatry & Neurology (Psychiatry)
11 ROUTE 111, PEDERSON-KRAG CENTER
SMITHTOWN, NY 11787
Psychiatry & Neurology (Psychiatry)
11 ROUTE 111
SMITHTOWN, NY 11787
Psychiatry & Neurology (Psychiatry)
11 ROUTE 111
SMITHTOWN, NY 11787
Social Worker (Clinical)
11 ROUTE 111
SMITHTOWN, NY 11787
Social Worker (Clinical)
11 ROUTE 111
SMITHTOWN, NY 11787

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407176209, enumerated as an "individual" on June 03, 2010.

The provider is located at 11 ROUTE 111 SMITHTOWN, NY 11787 and the phone number is (631) 920-8300.

Social Worker with taxonomy code 1041C0700X and a focus in Clinical.