Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. RAVEN DOMINGUEZ PHD, LP
NPI 1629770185
Psychologist - Clinical in Detroit, MI

Q: What is Raven Dominguez's NPI number?

The NPI number for Raven Dominguez is 1629770185. It was assigned to this individual provider in the NPPES registry on March 20, 2023.

Q: What is Raven Dominguez's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Raven Dominguez was last updated on October 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days 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.

Active since March 20, 2023

645 GRISWOLD ST RM 1164, DETROIT, MI 48226(313) 224-5205 Get Directions Write a Review

NPPES record last updated: October 5, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Oct 5, 2026, Mar 20, 2023 (2 updates tracked since 2023).

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About Dr. Raven Dominguez Phd, Lp NPPES

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

DR. RAVEN DOMINGUEZ PHD, LP (NPI 1629770185) is an individual clinical provider in Detroit, Michigan, licensed in Michigan (6301019948) and active in the NPI registry since March 2023.

NPPES Registry Identity

NPI1629770185

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. RAVEN DOMINGUEZCredential: PHD, LP

Location Address645 GRISWOLD ST RM 1164Detroit, MI 48226-4105

Mailing Address645 Griswold St Rm 1164Detroit, MI 48226-4105 · (313) 224-5205

Phone(313) 224-5205

Sole ProprietorNo

Enumeration DateMarch 20, 2023

Last NPPES UpdateOctober 5, 20262 updates tracked since enumeration

NPPES CertifiedOctober 5, 2026

✔ NPI 1629770185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MI · 6301019948

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

645 GRISWOLD ST RM 1164, Detroit, MI 48226

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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 Raven Dominguez's NPI number?

The NPI number for Raven Dominguez is 1629770185. It was assigned to this individual provider in the NPPES registry on March 20, 2023.

Where is Raven Dominguez located?

Raven Dominguez practices at 645 Griswold St Rm 1164, Detroit, MI 48226. The listed phone number is (313) 224-5205.

What is Raven Dominguez's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Raven Dominguez was last updated on October 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days 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.