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

Mrs. Jessica Catherine Dominguez, LCSW

Individual provider Social Worker · NPI 1407176209

Mrs. Jessica Catherine Dominguez, LCSW is a Clinical Social Worker in Smithtown, New York. Qualified in 2009, 17 years ago. Practices with Welllife Network Inc, a 17-clinician group. Licensed in New York.

Years since qualifying
17
Licensed in
NY
In the registry since
2010
Specialties on file
2
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

11 Route 111
Smithtown, NY 11787-3712
Phone: (631) 920-8300
Fax: (631) 920-8460
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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 082105 (NY)
Social Worker Taxonomy 104100000X · Licence 080537-1 (NY)

Record details

NPI number1407176209
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJune 3, 2010
Last updated in NPPESAugust 20, 2015

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Welllife Network Inc — 17 clinicians
Accepts Medicare assignment Not indicated

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