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DOMINIQUEA EDMISTON LCSW
NPI 1619618212
Social Worker - Clinical in Statesville, NC

Active since April 06, 2022
806 PHILLIPS LN, STATESVILLE, NC 28625(602) 525-7997 Get Directions Write a Review

NPPES record last updated: August 4, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 4, 2024, Jun 11, 2022, Apr 6, 2022 (3 updates tracked since 2022).

About Dominiquea Edmiston Lcsw NPPES

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

DOMINIQUEA EDMISTON LCSW (NPI 1619618212) is an individual clinical provider in Statesville, North Carolina, licensed in Arizona (20424) and active in the NPI registry since April 2022. She maintains a secondary practice location in Tempe.

NPPES Registry Identity

NPI1619618212
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameDOMINIQUEA EDMISTONCredential: LCSW
Location Address806 PHILLIPS LNStatesville, NC 28625-4596
Mailing Address806 Phillips LnStatesville, NC 28625-4596 · (602) 525-7997
Phone(602) 525-7997
Sole ProprietorNo
Enumeration DateApril 6, 2022
Last NPPES UpdateAugust 4, 20243 updates tracked since enumeration
NPPES CertifiedJuly 20, 2022
✔ NPI 1619618212 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 AZ · 20424
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 18434 (AZ)
806 PHILLIPS LN, Statesville, NC 28625
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Secondary Practice Location 1

Location 11115 E Lemon StTempe, AZ 85281-4028 · Phone (602) 525-7997

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, UnitedHealthcare.Insurance ›

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 Dominiquea Edmiston's NPI number?

The NPI number for Dominiquea Edmiston is 1619618212. It was assigned to this individual provider in the NPPES registry on April 6, 2022.

Where is Dominiquea Edmiston located?

Dominiquea Edmiston practices at 806 Phillips Ln, Statesville, NC 28625. The listed phone number is (602) 525-7997.

What is Dominiquea Edmiston's specialty?

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

What insurance does Dominiquea Edmiston accept?

Health plans from Blue Cross Blue Shield of Arizona and UnitedHealthcare list Dominiquea Edmiston 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 Dominiquea Edmiston was last updated on August 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.