Individual provider · Type 1 NPI

Eugene Domenico, PHD LCSW

Mental Health Counselor · Lockport, NY

NPI number 1679608103 Active

Practice location

Market Street, Bewley Building Suite #437
Lockport, NY 14094

Call (716) 438-2436 Map

Fax (716) 438-2435

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X034738-1 (NY)
Clinical Social Worker 1041C0700X034738-1 (NY)
Psychologist 103T00000X034738-1 (NY)

Mental Health Counselor: Definition to come...

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About NPI 1679608103

Eugene Domenico, PHD LCSW's National Provider Identifier is 1679608103, issued on Feb 23, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lockport, NY. The record was last updated on Dec 16, 2009.