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DOMINIQUE MICHELLE MANGANO MACK LAC
NPI 1639925191
Counselor - Mental Health in Goodyear, AZ

Active since April 25, 2024
13471 W CORNERSTONE BLVD, GOODYEAR, AZ 85395(480) 964-2273 Get Directions Write a Review

NPPES record last updated: May 1, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 1, 2024, Apr 25, 2024 (2 updates tracked since 2024).

About Dominique Michelle Mangano Mack Lac NPPES

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

DOMINIQUE MICHELLE MANGANO MACK LAC (NPI 1639925191) is an individual mental health provider in Goodyear, Arizona, licensed in Arizona (LAC-22735) and active in the NPI registry since April 2024.

NPPES Registry Identity

NPI1639925191
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameDOMINIQUE MICHELLE MANGANO MACKCredential: LAC
Location Address13471 W CORNERSTONE BLVDGoodyear, AZ 85395-2713
Mailing Address19819 W Marshall AveLitchfield Park, AZ 85340-5426 · (708) 209-9952
Phone(480) 964-2273
Sole ProprietorNo
Enumeration DateApril 25, 2024
Last NPPES UpdateMay 1, 20242 updates tracked since enumeration
NPPES CertifiedMay 1, 2024
✔ NPI 1639925191 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in AZ · LAC-22735
13471 W CORNERSTONE BLVD, Goodyear, AZ 85395
Open in Google Maps ↗

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.

LESLIE MYA ALMANZA
Behavior Technician
13471 W CORNERSTONE BLVD
GOODYEAR, AZ 85395
Maricopa County (877) 809-5092
DIANA V PEREZ
Case Manager/Care Coordinator
13471 W CORNERSTONE BLVD
GOODYEAR, AZ 85395
Maricopa County (877) 809-5092
GRACE MARY RUETTINGER PA
Nurse Practitioner (Psychiatric/Mental Health)
13471 W CORNERSTONE BLVD
GOODYEAR, AZ 85395
Maricopa County (480) 964-2273
MRS. CHERRIEE MILYNN DESHONG WHNP
Nurse Practitioner (Women's Health)
13471 W CORNERSTONE BLVD
GOODYEAR, AZ 85395
Maricopa County (480) 964-2273
MELIA KAY COX DO
Family Medicine
13471 W CORNERSTONE BLVD
GOODYEAR, AZ 85395
Maricopa County (877) 809-5092
BONTE GBEMUDU M.D.
Family Medicine
13471 W CORNERSTONE BLVD
GOODYEAR, AZ 85395
Maricopa County (877) 809-5092
DR. MARKETTA TOLIVER DNP, APRN, FNP-C
Nurse Practitioner (Family)
13471 W CORNERSTONE BLVD
GOODYEAR, AZ 85395
Maricopa County (480) 964-2273
ADELANTE HEALTHCARE INC
Pharmacy (Clinic Pharmacy)
13471 W CORNERSTONE BLVD
GOODYEAR, AZ 85395
Maricopa County (844) 551-6691

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 Dominique Mangano Mack's NPI number?

The NPI number for Dominique Mangano Mack is 1639925191. It was assigned to this individual provider in the NPPES registry on April 25, 2024.

Where is Dominique Mangano Mack located?

Dominique Mangano Mack practices at 13471 W Cornerstone Blvd, Goodyear, AZ 85395. The listed phone number is (480) 964-2273.

What is Dominique Mangano Mack's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Dominique Mangano Mack was last updated on May 1, 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.