MR. MATTHEW DAVID DOMICO (NPI# 1790999191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790999191 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW DAVID DOMICO |
| Credential | MSW, LSW |
| Practice Address |
34 Phelps Ave Romeoville IL 60446-1388 |
| Practice Telephone | 8153728950 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101Y00000X | Counselor | IL | Behavioral Health & Social Service Providers | |
| X | 104100000X | Social Worker | IL | Behavioral Health & Social Service Providers |
| Street Address |
34 PHELPS AVE |
| City | ROMEOVILLE |
| State | IL |
| Zip Code | 60446-1388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992927552 | Therese M Lawrence | Counselor | 34 Phelps Ave, Romeoville, IL 60446-1388 | 2007-05-03 |
| 1235449299 | Geneva Dodson | Social Worker | 34 Phelps Ave, Romeoville, IL 60446-1388 | 2010-10-08 |
| 1891965364 | Corin D Hammond | Social Worker | 34 Phelps Ave, Romeoville, IL 60446-1388 | 2008-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184254393 | Gary Smith | Counselor | 97 Olde English, Romeoville, IL 60446 | 2020-01-16 |
| 1417463399 | Marlene Marie Dunleavy | Psychologist | 590 Belmont Drive, Romeoville, IL 60446 | 2017-12-14 |
| 1821516493 | Catherine Dupee | Speech-Language Pathologist | 100 N. Independence Blvd., Romeoville, IL 60446 | 2017-09-05 |
| 1396297370 | Erin Nicole Richardson | Social Worker | 500 South Weber Road, Romeoville, IL 60446 | 2016-10-26 |
| 1477948636 | Lenita Hinkle | Nurse Practitioner | 1262 Le Moyne Avenue, Romeoville, IL 60446 | 2015-04-03 |
| 1679996516 | Lea Institute Inc. | Naprapath | 600 S. Weber Rd., Suite 5, Romeoville, IL 60446 | 2014-01-29 |
| 1255768941 | Brian Froelich | Social Worker | 1289 Windham Parkway, Romoeville, IL 60446 | 2013-09-26 |
| 1346584513 | Lifeclinic Chiropractic of Illinois LLC | Chiropractor | 1220 Lakeville Drive, Romeoville, IL 60446 | 2012-11-12 |
| 1114290475 | Joliet Dialysis Holdings, LLC | Internal Medicine | 368 S. Weber Road, Romeoville, IL 60446 | 2012-02-17 |
| 1548570104 | Amazing Grace Health Services Inc. | Home Health | 1477 Snapdragon Court, Romeoville, IL 60446 | 2010-10-18 |
| Find all providers in zip 60446 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184254393 | Gary Smith | Counselor | 97 Olde English, Romeoville, IL 60446 | 2020-01-16 |
| 1992927552 | Therese M Lawrence | Counselor | 34 Phelps Ave, Romeoville, IL 60446-1388 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922813 | Valerie Ann Taylor | Counselor | 1230 N Washington Ave, Batavia, IL 60510-1369 | 2020-11-07 |
| 1073114088 | Astrid Larsen | Counselor | 2317 Timberline Trl, Woodstock, IL 60098-8759 | 2020-11-05 |
| 1932708690 | Mucci World Management Inc,. | Counselor | 7913 171st St, Tinley Park, IL 60477-3244 | 2020-10-22 |
| 1679172373 | Alexander Czop | Counselor | 1250 Chestnut Ave, Wilmette, IL 60091-1616 | 2020-10-22 |
| 1427656859 | Mica Coleman | Counselor | 5800 Allemong Dr, Matteson, IL 60443-1108 | 2020-10-16 |
| 1386242873 | Kelly Mann | Counselor | 301 S Henry St, Ashkum, IL 60911-7119 | 2020-10-15 |
| 1245838549 | Erika Leigh Heatley | Counselor | 32w755 Albert Dr, East Dundee, IL 60118-3202 | 2020-10-09 |
| 1851999080 | Linda D Odaniel | Counselor | 12904 Division St Apt 2a, Blue Island, IL 60406-3420 | 2020-10-09 |
| 1366058075 | Allyssa Rose Bertram | Counselor | 4055 W Peterson Ave Ste 202, Chicago, IL 60646-6183 | 2020-09-17 |
| 1952914707 | Tara Ufer | Counselor | 400 W Deming Pl Apt 9g, Chicago, IL 60614-1702 | 2020-08-30 |
| Find all providers with the same taxonomy | ||||
| City | ROMEOVILLE |
| Zip Code | 60446 |
Please comment or provide details below to improve the information on MR. MATTHEW DAVID DOMICO.
| 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.