DOMONIQUE BLACKMON (NPI# 1770963597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770963597 |
| Entity Type | Individual |
| Full Name | DOMONIQUE BLACKMON |
| Credential | M.S., LPCA |
| Practice Address |
1708 Trawick Rd Suite 101 Raleigh NC 27604-3897 |
| Mailing Address |
2816 Vanstory St Greensboro NC 27407-4844 |
| Practice Telephone | 9198967536 |
| Practice Fax Number | 9198967537 |
| Mailing Telephone | 7572142423 |
| Enumeration Date | 2015-06-06 |
| Last Update Date | 2015-06-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
A11622 | NC | Behavioral Health & Social Service Providers |
| Street Address |
1708 TRAWICK RD SUITE 101 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27604-3897 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992717292 | Kara B. Willette | Nurse Practitioner | 1708 Trawick Rd, Suite 111, Raleigh, NC 27604-3897 | 2006-08-13 |
| 1881091767 | Esteban Minsk | Counselor | 1708 Trawick Rd, Raleigh, NC 27604-3897 | 2014-11-20 |
| 1548664097 | Kathryn Sutton | Counselor | 1708 Trawick Rd, Suite 101, Raleigh, NC 27604-3897 | 2014-10-13 |
| 1023419256 | John Thomas Schweichler | Marriage & Family Therapist | 1708 Trawick Rd, Suite 101, Raleigh, NC 27604-3897 | 2014-09-08 |
| 1558777284 | Katharine Sileo | Marriage & Family Therapist | 1708 Trawick Rd, Suite 101, Raleigh, NC 27604-3897 | 2014-07-02 |
| 1477974590 | Demah Payne IIi | Counselor | 1708 Trawick Rd, Raleigh, NC 27604-3897 | 2013-12-16 |
| 1760813752 | Kevin Smith | Marriage & Family Therapist | 1708 Trawick Rd, Suite 101, Raleigh, NC 27604-3897 | 2013-12-02 |
| 1417296542 | Jean Marie Veedock | Counselor | 1708 Trawick Rd, Raleigh, NC 27604-3897 | 2013-02-08 |
| 1538298153 | Eagle Healthcare Services Inc. | Community/Behavioral Health | 1708 Trawick Rd, Raleigh, NC 27604-2180 | 2007-03-02 |
| 1225107048 | Marquita Pleshette Lyons | Nurse Practitioner | 1708 Trawick Rd, Suite 111, Raleigh, NC 27604-3897 | 2006-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326669748 | Monet Josey | Counselor | 3020 Highwood Blvd, Raleigh, NC 27604 | 2020-04-27 |
| 1154979094 | Ride4health Transportation Inc | Non-emergency Medical Transport (VAN) | 3200 Capital Blvd, Raleigh, NC 27604 | 2019-09-03 |
| 1851890750 | Sasilana Letreva Burden | In Home Supportive Care | 4000 Northstone Drive Apt 307, Raleigh, NC 27604 | 2018-02-06 |
| 1093226383 | The Eye Institute Od, Pa | Optometrist | 111 Seaboard Ave Ste 110, Raleigh, NC 27604 | 2017-10-13 |
| 1902326044 | Ngozi Ifeoma Osiebo | Nurse Practitioner | 4608 Wedgewood Drive, Raleigh, NC 27604 | 2017-06-20 |
| 1144765520 | Rose Hill Family Care Home | Custodial Care Facility | 1705 Beacon Bluff Street, Raleigh, NC 27604 | 2016-12-21 |
| 1437609948 | Mercy Manor At Saybrooke, Inc | Custodial Care Facility | 6320 Saybrooke Drive, Raleigh, NC 27604 | 2016-10-07 |
| 1972969913 | Shivas Gilotra | Nurse Practitioner | 805 Oberlin Road, Ste 200, Raleigh, NC 27604 | 2016-01-06 |
| 1609247915 | Charisse Justine Young | Social Worker | 2609 Atlantic Avenue, Suite 111c, Raleigh, NC 27604 | 2015-10-13 |
| 1356748933 | John T Hart | Counselor | 1115-113 Cove Bridge Road, Raleigh, NC 27604 | 2014-11-26 |
| Find all providers in zip 27604 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007759 | James Carroll Pittman IIi | Counselor | 2301 Stonehenge Dr Ste 110, Raleigh, NC 27615-4379 | 2020-09-09 |
| 1043820715 | Keep Counsel | Counselor | 8320 Hardeth Way, Raleigh, NC 27616-3237 | 2020-08-06 |
| 1023647047 | Lets Cope Counseling Services Pllc | Counselor | 1631 Midtown Pl Ste 104-126, Raleigh, NC 27609-1300 | 2020-04-02 |
| 1841834785 | Vernetta J Davis | Counselor | 6604 Six Forks Rd Ste 101, Raleigh, NC 27615-6521 | 2019-11-04 |
| 1053955187 | Kelsie Ann Adkisson | Counselor | 5171 Glenwood Ave Ste 221, Raleigh, NC 27612-3266 | 2019-10-31 |
| 1841841012 | Galana Tennille Chookolingo | Counselor | 1123 Ileagnes Rd, Raleigh, NC 27603-2378 | 2019-09-27 |
| 1720639917 | Kelly Marie Nelson | Counselor | 205 Delway St Unit A, Raleigh, NC 27604-1131 | 2019-09-27 |
| 1720649890 | Maryann Kathryn Garcia | Counselor | 5805 Hampton Ridge Rd, Raleigh, NC 27603-9259 | 2019-06-27 |
| 1568929503 | Kelly Harrison Counseling Pllc | Counselor | 3200 Wake Forest Rd Ste 204, Raleigh, NC 27609-7451 | 2019-02-26 |
| 1639645278 | Donald G Wiggins | Counselor | 7516 Longstreet Dr, Raleigh, NC 27615-6131 | 2018-10-22 |
| Find all providers in RALEIGH | ||||
Please comment or provide details below to improve the information on DOMONIQUE BLACKMON.
| 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.