MS. SANDRA ELIZABETH DOMICO (NPI# 1306399944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306399944 |
| Entity Type | Individual |
| Full Name | MS. SANDRA ELIZABETH DOMICO |
| Credential | LCSW |
| Practice Address |
355 Ridge Ave 2nd Floor Evanston IL 60202-3328 |
| Mailing Address |
1623 W Fargo Ave 1 Chicago IL 60626-1771 |
| Practice Telephone | 8473166262 |
| Mailing Telephone | 7735975187 |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2016-08-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149.018069 | IL | Behavioral Health & Social Service Providers |
| Street Address |
355 RIDGE AVE 2ND FLOOR |
| City | EVANSTON |
| State | IL |
| Zip Code | 60202-3328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750380820 | James Douglas Glass | Anesthesiology | 355 Ridge Ave, Evanston, IL 60202-3328 | 2005-07-20 |
| 1710588496 | Paritosh Prasai | Student in an Organized Health Care Education/Training Program | 355 Ridge Ave, Evanston, IL 60202-3328 | 2020-11-08 |
| 1750989653 | Emre Can Ozcekirdek | Student in an Organized Health Care Education/Training Program | 355 Ridge Ave, Evanston, IL 60202-3328 | 2020-10-13 |
| 1689288664 | Bidhya Poudel | Student in an Organized Health Care Education/Training Program | 355 Ridge Ave, Evanston, IL 60202-3328 | 2020-09-07 |
| 1578177614 | Pankaj Luitel | Student in an Organized Health Care Education/Training Program | 355 Ridge Ave, Evanston, IL 60202-3399 | 2020-09-05 |
| 1184238289 | Qishuo Zhang | Internal Medicine | 355 Ridge Ave, Evanston, IL 60202-3328 | 2020-09-04 |
| 1184238297 | Kritika Yadav | Student in an Organized Health Care Education/Training Program | 355 Ridge Ave, Evanston, IL 60202-3328 | 2020-09-04 |
| 1205440427 | Bimatshu Pyakuryal | Student in an Organized Health Care Education/Training Program | 355 Ridge Ave, Evanston, IL 60202-3399 | 2020-09-04 |
| 1689288904 | Arjab Adhikari | Student in an Organized Health Care Education/Training Program | 355 Ridge Ave, Evanston, IL 60202-3328 | 2020-09-03 |
| 1205449014 | Rameej Revanta Thapa | Student in an Organized Health Care Education/Training Program | 355 Ridge Ave, Evanston, IL 60202-3328 | 2020-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548889496 | Ktsmiles, Inc | Clinic/Center | 2408 Main Street, Evanston, IL 60202 | 2020-04-10 |
| 1831751163 | Dorcas Matowe | Marriage & Family Therapist | The Family Institute, 618 Library Place, Evanston, IL 60202 | 2019-07-08 |
| 1457847170 | Lilah Handler | Social Worker | 905 Forest Ave, Apt 1, Evanston, IL 60202 | 2018-07-05 |
| 1528574472 | Jessica Kubacki | Developmental Therapist | 535 Hinman Ave Apt F3, Evanston, IL 60202 | 2017-12-14 |
| 1376075853 | Lisa Meyerson Acupuncture | Acupuncturist | 1234 Sherman Avenue, Lighthouse Yoga and Acupuncture, Evanston, IL 60202 | 2017-04-03 |
| 1427597368 | Lillian Obucina Dds PC | Dentist | 111 North Wabash, Suite 1522, Chicago, IL 60202 | 2017-02-13 |
| 1184176893 | Amelia Willcox | Speech-Language Pathologist | 620 Sheridan Square, Apartment 1, Evanston, IL 60202 | 2016-10-28 |
| 1831547785 | Thomas Hagerty Jr. | Pharmacist | 2491 W Howard St, Evanston, IL 60202 | 2016-06-01 |
| 1013361948 | Autism Hope Support | In Home Supportive Care | 815 Seward Apt. 1s, Evanston, IL 60202 | 2016-04-18 |
| 1215302625 | Preferred Dentistry Associates, LLC | Dentist | 1029 Howard Street, Evanston, IL 60202 | 2015-12-10 |
| Find all providers in zip 60202 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588276406 | Meredith S Alger | Social Worker | 1815 Seward St, Evanston, IL 60202-1905 | 2020-08-21 |
| 1568090678 | Ashley Ice | Social Worker | 200 Ridge Ave Apt 1c, Evanston, IL 60202-3855 | 2020-04-01 |
| 1801420971 | Solidarity Therapy Services LLC | Social Worker | 733 Dobson St Apt 2s, Evanston, IL 60202-3977 | 2020-02-27 |
| 1649804188 | Singlepoint Psychotherapy | Social Worker | 1234 Sherman Ave Ste 109, Evanston, IL 60202-1375 | 2020-02-24 |
| 1215571658 | Wendy Kopald | Social Worker | 1740 Ridge Ave Ste 200-c, Evanston, IL 60201-5918 | 2019-10-29 |
| 1477104396 | Eleanor Pierson | Social Worker | 1865 Sherman Ave, Evanston, IL 60201-3714 | 2019-09-23 |
| 1043860125 | Adrienne Groff | Social Worker | 2309 Forestview Rd, Evanston, IL 60201-2011 | 2019-09-19 |
| 1992351712 | Christine Sofia Leone | Social Worker | 235 Custer Ave Apt 2s, Evanston, IL 60202-3597 | 2019-08-16 |
| 1780237669 | Suzanne Nicole Hawley | Social Worker | 1617 South Blvd, Evanston, IL 60202-2745 | 2019-07-19 |
| 1124587449 | Julie Noparstak | Social Worker | 990 Grove St Ste 401, Evanston, IL 60201-4370 | 2019-03-16 |
| Find all providers in EVANSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.