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MARCIA DOMECQ LCSW
NPI 1649445669
Counselor - Mental Health in Superior, WI

Active since April 30, 2008PECOS Enrolled
3500 TOWER AVE, ESSENTIA HEALTH ST, MARY'S-SUPERIOR CLINIC, SUPERIOR, WI 54880(715) 817-7100 Get Directions Write a Review

NPPES record last updated: December 2, 2015. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Marcia Domecq Lcsw NPPES

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

MARCIA DOMECQ LCSW (NPI 1649445669) is an individual mental health provider in Superior, Wisconsin, licensed in Wisconsin (3965-123) and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS and is a graduate of Other (1995).

NPPES Registry Identity

NPI1649445669
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMARCIA DOMECQCredential: LCSW
Location Address3500 TOWER AVE, ESSENTIA HEALTH ST, MARY'S-SUPERIOR CLINICSuperior, WI 54880-4491
Mailing Address3500 Tower Ave, Essentia Health St, Mary's-superior ClinicSuperior, WI 54880-4491 · (715) 817-7100
Phone(715) 817-7100
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateApril 30, 2008
Last NPPES UpdateDecember 2, 2015
✔ NPI 1649445669 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 WI · 3965-123
3500 TOWER AVE, Superior, WI 54880
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Sanford Health Plan, Security Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marcia Domecq Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8325521370
PECOS Enrollment IDI20260309002422
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.

Medicare Billing Reassignment

Medicare enrollment records show Marcia Domecq reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St. Mary's Hospital Of Superior
Same address
Emergency Care
3500 TOWER AVE
Superior, WI 54880
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: St Marys Hospital Of Superior
  • 381 clinicians in this Medicare group
NPI 1700817079 (715) 395-5400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

MS. ERIN LEE FISKER PA-C
Physician Assistant
3500 TOWER AVE
SUPERIOR, WI 54880
Douglas County (715) 817-7100
GEORGIA DIMOS BRUNETTE
Internal Medicine
3500 TOWER AVE
SUPERIOR, WI 54880
Douglas County (715) 395-5454
MR. GREGORY STEPHAN VERGAMINI PT, ATC
Physical Therapist (Sports)
3500 TOWER AVE
SUPERIOR, WI 54880
Douglas County (715) 395-5454
DR. JUSTIN BRIAN SPORLEDER MD
Hospitalist
3500 TOWER AVE
SUPERIOR, WI 54880
Douglas County (218) 786-8364
KATHERINE ADELE HAAS PHARMD
Pharmacist
3500 TOWER AVE
SUPERIOR, WI 54880
Douglas County (715) 817-7100
MEGAN E. LIEBAERT
Physical Therapist
3500 TOWER AVE
SUPERIOR, WI 54880
Douglas County (715) 395-5400
RHIANNON ELISE GRIMM PA-C
Physician Assistant
3500 TOWER AVE
SUPERIOR, WI 54880
Douglas County (715) 817-7100
ST. MARY'S HOSPITAL OF SUPERIOR
General Acute Care Hospital (Critical Access)
3500 TOWER AVE
SUPERIOR, WI 54880
Douglas County (715) 395-5400

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 Marcia Domecq's NPI number?

The NPI number for Marcia Domecq is 1649445669. It was assigned to this individual provider in the NPPES registry on April 30, 2008.

Where is Marcia Domecq located?

Marcia Domecq practices at 3500 Tower Ave Essentia Health St, Mary's-Superior Clinic, Superior, WI 54880. The listed phone number is (715) 817-7100.

What is Marcia Domecq's specialty?

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

Is Marcia Domecq enrolled in Medicare?

Yes. Marcia Domecq is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Marcia Domecq's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marcia Domecq reassigns Medicare benefits to St. Mary's Hospital Of Superior (Superior, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marcia Domecq's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Marcia Domecq accept?

Health plans from HealthPartners, Sanford Health Plan, Security Health Plan and UnitedHealthcare list Marcia Domecq 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 Marcia Domecq was last updated on December 2, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.