Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dominique Latrece Squire, LCSW

Individual provider Clinical Social Worker · NPI 1174125322

Dominique Latrece Squire, LCSW is a Clinical Social Worker in Winterville, North Carolina. Qualified in 2019, 7 years ago. Practices as a sole proprietor. Licensed in North Carolina.

Years since qualifying
7
Licensed in
NC
In the registry since
2020
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

575 S Square Dr Apt 103
Winterville, NC 28590-8699
Phone: (919) 423-7483
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence C017135 (NC)

Record details

NPI number1174125322
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedNovember 12, 2020
Last updated in NPPESMay 22, 2024
Certification dateMay 22, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated

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