MEDICARE: CELINDA DOMINGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1972436640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELINDA DOMINGUEZ

Provider Business Mailing Address
First Line	:	914 CORNERSTONE PL
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-1829
Country	:	US
Telephone Number	:	702-672-9845
Fax Number	:

Provider Business Practice Location Address
First Line	:	6048 S DURANGO DR STE 115
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-1781
Country	:	US
Telephone Number	:	702-815-1550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ CELINDA DOMINGUEZ ” Practice Location

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