National Provider Identifier
Eugene Domenico, PHD LCSW
Eugene Domenico, PHD LCSW is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Lockport, NY and a listed phone number of (716) 438-2436.
Profile Overview
- NPI
- 1679608103
- Provider Type
- Individual
- Primary Specialty
- Mental Health Counselor
- Enumeration Date
- February 23, 2007
- Last Updated
- December 16, 2009
Practice Location
- Market Street
- Bewley Building Suite #437
- Lockport, NY 14094
Phone: (716) 438-2436
Specialties
- Mental Health Counselor (101YM0800X)
- Clinical Social Worker (1041C0700X)
- Psychologist (103T00000X)
Full Record
- NPI
- 1679608103
- Entity Type
- Individual
- Last Name
- Domenico
- First Name
- Eugene
- Name Prefix
- Dr.
- Credential
- PHD LCSW
- Mailing Street Address
- Market Street
- Mailing Address Line 2
- Bewley Building Suite #437
- Mailing City
- Lockport
- Mailing State
- NY
- Mailing ZIP Code
- 14094
- Mailing Country
- US
- Mailing Phone
- (716) 438-2436
- Mailing Fax
- (716) 438-2435
- Practice Street Address
- Market Street
- Practice Address Line 2
- Bewley Building Suite #437
- Practice City
- Lockport
- Practice State
- NY
- Practice ZIP Code
- 14094
- Practice Country
- US
- Practice Phone
- (716) 438-2436
- Practice Fax
- (716) 438-2435
- Enumeration Date
- February 23, 2007
- Last Updated
- December 16, 2009
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Mental Health Counselor (101YM0800X), Clinical Social Worker (1041C0700X), Psychologist (103T00000X)
- Other Identifiers
- 00020255501 (NY, Univera), 000511600005 (NY, BCBS)