Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Mary Elizabeth Domino, LCSW-C

Individual provider Clinical Social Worker · NPI 1760666424

Mrs. Mary Elizabeth Domino, LCSW-C is a Clinical Social Worker in Centreville, Maryland. Qualified in 1991, 35 years ago. Practices with Corsica River Mental Health Services, Inc, a 9-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Maryland.

Years since qualifying
35
Licensed in
MD
In the registry since
2007
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Practice location Address checks out

120 Banjo Ln
Centreville, MD 21617
Phone: (410) 758-3050
Fax: (410) 758-0698
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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 10791 (MD)

Record details

NPI number1760666424
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW-C
Sole proprietorNo
NPI enumeratedDecember 18, 2007
Last updated in NPPESOctober 4, 2023
Certification dateOctober 4, 2023

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1991 (35 years in practice)
Group practice Corsica River Mental Health Services, Inc. — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Centreville