LAUREL DOMINO (NPI# 1982179669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982179669 |
| Entity Type | Individual |
| Full Name | LAUREL DOMINO |
| Credential | BCBA |
| Practice Address |
2979 Pga Blvd # 200 Palm Beach Gardens FL 33410-2911 |
| Mailing Address |
1161 Lake Cook Rd Deerfield IL 60015-5649 |
| Practice Telephone | 8139810815 |
| Mailing Telephone | 8474985437 |
| Mailing Fax Number | 8474985438 |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2020-10-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103K00000X | Behavioral Analyst | 1-20-45053 | FL | Behavioral Health & Social Service Providers |
| Y | 106S00000X | Behavior Technician | RBT-18-67044 | IL | Behavioral Health & Social Service Providers |
| Street Address |
2979 PGA BLVD # 200 |
| City | PALM BEACH GARDENS |
| State | FL |
| Zip Code | 33410-2911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366937088 | Krystal Maya Khemkaran | Behavior Technician | 2979 Pga Blvd # 200, Palm Beach Gardens, FL 33410 | 2018-06-25 |
| 1760081384 | Rebekah Woodruff | Behavior Technician | 2979 Pga Blvd # 200, Palm Beach Gardens, FL 33410-2911 | 2020-10-23 |
| 1699392365 | Chloe Greene | Behavior Technician | 2979 Pga Blvd # 200, Palm Beach Gardens, FL 33410-2911 | 2020-06-29 |
| 1184259202 | Triton Payne | Behavior Technician | 2979 Pga Blvd # 200, Palm Beach Gardens, FL 33410-2911 | 2020-03-09 |
| 1295209922 | Jaymi Blossom Feeney | Behavior Technician | 2979 Pga Blvd # 200, Palm Beach Gardens, FL 33410-2911 | 2019-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811501026 | Vicky Pauline Salazar | Registered Nurse | 11501 N Military Trail, Palm Beach Gardens, FL 33410 | 2020-09-04 |
| 1417596388 | Chavon E Mayer | Doula | 149 Winter Park Lane, West Palm Beach, FL 33410 | 2019-12-24 |
| 1639711617 | Diamond Physical Therapy, LLC | Physical Therapist | 4025 Johnson Dairy Road, Palm Beach Gardens, FL 33410 | 2019-10-11 |
| 1689151714 | Caroline Devries Hesterman | Occupational Therapist | 9840 Alternate A1a Ste 402, Palm Beach Gardens, FL 33410 | 2018-07-21 |
| 1548762552 | Arsenia Pomperada Sabusap | Nurse Practitioner | Grace Medical Center of Florida, 4212 Northlake Blvd., Palm Beach Gardens, FL 33410 | 2018-03-06 |
| 1538668199 | Alan Seidenfeld | Dentist | 7305 N Military Trl 3a-200, Riviera Beach, FL 33410 | 2018-02-08 |
| 1407361454 | Nuvista Living At Jupiter, LLC | Skilled Nursing Facility | 338 Pioneer Road, Jupiter, FL 33410 | 2017-12-12 |
| 1083125728 | Tom Long Biddle-xing | Nurse Practitioner | 3345 Burns Rd Ste 206, Palm Beach Gardens, FL 33410 | 2017-10-20 |
| 1801315189 | Kasie Sidman | Physical Therapist | 3929 Bluebell St, Palm Beach Gardens, FL 33410 | 2017-09-18 |
| 1932627171 | Neuro Consultants LLC | Psychiatry & Neurology | 3502 Kyoto Gardens Drive, Sutie A, Palm Beach Gardens, FL 33410 | 2017-09-08 |
| Find all providers in zip 33410 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508473208 | Saskia Ridley | Behavior Technician | 3801 Pga Blvd Ste 600&602, Palm Beach Gardens, FL 33410-2758 | 2020-09-26 |
| 1649805128 | Lauren Bologna | Behavior Technician | 2 Guillard Ct, Palm Beach Gardens, FL 33418-7040 | 2020-03-05 |
| 1124658323 | Lisbet Herrera | Behavior Technician | 4092 Rochester St, Palm Beach Gardens, FL 33410-5964 | 2020-01-16 |
| 1366937088 | Krystal Maya Khemkaran | Behavior Technician | 2979 Pga Blvd # 200, Palm Beach Gardens, FL 33410 | 2018-06-25 |
| 1659864049 | Tara E Turene | Behavior Technician | 900 Burma Road, Suit 109, Palm Beach Gardens, FL 33403 | 2018-06-11 |
| 1902302904 | Jessica Perez | Behavior Technician | 3750 Dunes Rd, Palm Beach Gardens, FL 33410-2346 | 2018-03-30 |
| 1669985560 | Michele Johnson | Behavior Technician | 5902 Golden Eagle Cir, Palm Beach Gardens, FL 33418-1528 | 2017-11-14 |
| 1245776863 | Stefanie Kenney | Behavior Technician | 5953 Golden Eagle Cir, Palm Beach Gardens, FL 33418-1531 | 2017-01-07 |
| 1699376392 | Alaja Ellison | Behavior Technician | 2979 Pga Blvd Ste 200, Palm Beach Gardens, FL 33410-2911 | 2020-11-08 |
| 1598365355 | Zarria Llopis | Behavior Technician | 9000 Burma Rd Ste 109, Palm Beach Gardens, FL 33403-1606 | 2020-10-29 |
| Find all providers in PALM BEACH GARDENS | ||||
| City | PALM BEACH GARDENS |
| Zip Code | 33410 |
Please comment or provide details below to improve the information on LAUREL DOMINO.
| 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.