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

Dr. Eugene Domenico, PHDLCSW

Individual provider Mental Health Counselor · NPI 1679608103

Dr. Eugene Domenico, PHDLCSW is a Clinical Social Worker in Lockport, New York. Qualified in 1985, 41 years ago. Licensed in New York.

Years since qualifying
41
Licensed in
NY
In the registry since
2007
Specialties on file
3
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Practice location Partly verified

Some contact details are missing from the federal record.

Market Street Bewley Bldg Ste #437
Lockport, NY 14094
Phone: (716) 438-2436
Fax: (716) 438-2435
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 034738-1 (NY)
Clinical Social Worker Taxonomy 1041C0700X · Licence 034738-1 (NY)
Psychologist Taxonomy 103T00000X · Licence 034738-1 (NY)

Record details

NPI number1679608103
Entity typeIndividual (Type 1)
GenderMale
Credentials PHDLCSW
Sole proprietorNo
NPI enumeratedFebruary 23, 2007
Last updated in NPPESDecember 16, 2009
Mailing addressMarket Street, Bewley Building Suite #437, Lockport, NY 14094

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1985 (41 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Lockport