Individual provider · Type 1 NPI

Jessica Domke, LPC, ATR

Mental Health Counselor · Bridgeton, MO

NPI number 1083575989 Active

Practice location

12143 Old Saint Charles Rd
Bridgeton, MO 63044-2816

Call (314) 656-6113 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X2022037793 (MO)
Art Therapist 221700000XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1083575989

Jessica Domke, LPC, ATR's National Provider Identifier is 1083575989, issued on Nov 20, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Bridgeton, MO. The record was last updated on Nov 20, 2025.