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DEREIK LANCE DOMERESE LCSW
NPI 1760927586
Social Worker - Clinical in Lees Summit, MO

Active since January 03, 2017
905 NE RICE RD STE B, LEES SUMMIT, MO 64086(816) 223-8522 Get Directions Write a Review

NPPES record last updated: June 15, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dereik Lance Domerese Lcsw NPPES

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

DEREIK LANCE DOMERESE LCSW (NPI 1760927586) is an individual clinical provider in Lees Summit, Missouri, licensed in Missouri (2016034259) and active in the NPI registry since January 2017.

NPPES Registry Identity

NPI1760927586
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameDEREIK LANCE DOMERESECredential: LCSW
Location Address905 NE RICE RD STE BLees Summit, MO 64086-6300
Mailing Address2410 Sw State Route 150Lees Summit, MO 64082-2903 · (816) 223-8522
Phone(816) 223-8522
Sole ProprietorNo
Enumeration DateJanuary 3, 2017
Last NPPES UpdateJune 15, 2022
NPPES CertifiedJune 15, 2022
✔ NPI 1760927586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in MO · 2016034259✔ Licensed in KS · 10198
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.
905 NE RICE RD STE B, Lees Summit, MO 64086
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MIND SHIELD AND SWORD THERAPY, LLC
Social Worker (Clinical)
905 NE RICE RD STE B
LEES SUMMIT, MO 64086
Jackson County (816) 223-8522

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 Dereik Domerese's NPI number?

The NPI number for Dereik Domerese is 1760927586. It was assigned to this individual provider in the NPPES registry on January 3, 2017.

Where is Dereik Domerese located?

Dereik Domerese practices at 905 NE Rice Rd Ste B, Lees Summit, MO 64086. The listed phone number is (816) 223-8522.

What is Dereik Domerese's specialty?

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

When was this NPI record last updated?

The NPPES record for Dereik Domerese was last updated on June 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.