Richard John Domenico in Boston - Clinical
Richard John Domenico - NPI 1306915061
Richard John Domenico is a Clinical in Boston, Massachusetts. Richard John Domenico practices all healthcare services and medical treatments related to Clinical. The NPI Number for Richard John Domenico is 1306915061. The last update date is 2007-07-08.
Richard John Domenico's current location address is 607 Boylston St Fl 2, Boston, Massachusetts. You can contact this provider via phone number 6172662266 and fax number 6172666070. The mailing address for Richard John Domenico is 607 Boylston St Fl 2, Boston, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Richard John Domenico |
|---|---|
| Address | 607 Boylston St Fl 2, Boston, Massachusetts |
| Phone Number | 6172662266 |
| Fax Number | 6172666070 |
| Sole Proprietor | Y |
| Credentials | LICSW |
NPI Number Detail
| NPI Number | 1306915061 |
|---|---|
| Provider Enumeration Date | 2006-11-07 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 607 Boylston St Fl 2 |
|---|---|
| City | Boston |
| State | Massachusetts (MA) |
| Post Code | 21163604 |
| Phone Number | 6172662266 |
| Fax Number | 6172666070 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 1027486 |
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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, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| P07285 | MA | BCBS |
Post Comment/ Review Below
What is the unique identifier code issued to Richard John Domenico by the Centers for Medicare & Medicaid Services (CMS)?
The Richard John Domenico has been assigned the NPI (National Provider Identifier) 1306915061. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical location address where Richard John Domenico's facilities are situated?
The facilities of Richard John Domenico are physically located at the following address: 607 Boylston St Fl 2, Boston, MA, 21163604.
What is the Richard John Domenico's specialty and taxonomy code?
The Richard John Domenico's specialty is Clinical, and the corresponding taxonomy code is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1306915061 to Richard John Domenico?
The Centers for Medicare & Medicaid Services assigned the 1306915061 to Richard John Domenico on 2006-11-07.
As of what date was the information regarding Richard John Domenico, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Richard John Domenico, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.