TERESA M DOMBROWSKI LCDP
NPI 1528701638
Counselor - Addiction (Substance Use Disorder) in Cranston, RI

NPI Status: Active since April 16, 2022

Contact Information

1020 PARK AVE STE 108
CRANSTON, RI
ZIP 02910
Phone: (401) 396-7649

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  • Individual
  • Female
  • Years of Experience 5
  • Counselor
  • Addiction (Substance Use Disorder)
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About TERESA DOMBROWSKI

This page provides the complete NPI Profile along with additional information for Teresa Dombrowski, a provider established in Cranston, Rhode Island with a medical specialization in Counselor, focusing in addiction (substance use disorder) and more than 5 years of experience. The healthcare provider is registered in the NPI registry with number 1528701638 assigned on April 2022. The practitioner's primary taxonomy code is 101YA0400X with license number CDP00902 (RI). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1528701638
Provider Name
TERESA M DOMBROWSKI LCDP
Gender
Female
Entity Type
Individual
Location Address
1020 PARK AVE STE 108 CRANSTON, RI 02910
Location Phone
(401) 396-7649
Mailing Address
66 PLANET AVE RIVERSIDE, RI 02915
Mailing Phone
(401) 396-7649
Mailing Fax
Medical School Name
OTHER
Graduation Year
2021
Is Sole Proprietor?
Yes
Enumeration Date
04-16-2022
Last Update Date
04-16-2022
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A Substance Abuse or Addiction Counselor like Teresa Dombrowski advices patients who experience alcoholism, drug addiction, eating disorders, mental health issues, or other mental or behavioral problems. Substance Abuse counselors provide treatment and support to help clients recover from addiction or modify problem behaviors. Many counselors incorporate the principles of 12-step programs, such as Alcoholics Anonymous (AA). They educate clients how to cope with stress and life’s issues in ways that help them recover. Counselors also help patients improve their personal relationships and find ways to discuss their addiction or other problems with family and friends.

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

Counselor Addiction (Substance Use Disorder)

Taxonomy Code
101YA0400X
Type
Behavioral Health & Social Service Providers
License No.
CDP00902
License State
RI

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • NH Local Choice HMO Bronze 8000 + $0 Rx list + $0 Virtual Urgent Care - HMO
  • NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care - HMO
  • NH Local Choice HMO Gold 1400 + $0 Rx list + $0 Virtual Urgent Care - HMO
  • NH Local Choice HMO HSA Bronze 6000 - HMO
  • NH Local Choice HMO Silver 3500 + $0 Rx list + $0 Virtual Urgent Care - HMO
  • NH Local Choice HMO Silver 5000 + $0 Rx list + $0 Virtual Urgent Care - HMO
  • NH Local HMO Bronze 7500 Standard + $0 Rx list + $0 Virtual Urgent Care - HMO
  • NH Local HMO Gold 2000 Standard + $0 Rx list + $0 Virtual Urgent Care - HMO
  • NH Local HMO Silver 6000 Standard + $0 Rx list + $0 Virtual Urgent Care - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Teresa Dombrowski is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Teresa Dombrowski is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 9032552674

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20240209003550

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: No

Reviews for TERESA M DOMBROWSKI LCDP

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1528701638, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
2
Doubled → 4
Pos 4
8
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
0
Unchanged
Pos 7
1
Doubled → 2
Pos 8
6
Unchanged
Pos 9
3
Doubled → 6
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 7 → 14 → 5 1 → 2 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 4 + 8 + 1 + 4 + 0 + 2 + 6 + 6 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1528701638.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1528701638, enumerated as an "individual" on April 16, 2022.

The provider is located at 1020 PARK AVE STE 108 CRANSTON, RI 02910 and the phone number is (401) 396-7649.

Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).

The provider might be accepting Accepts: Harvard Pilgrim Health Care. Please consult your insurance carrier or call the provider to verify.