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NPI Code Detail

MEDICARE: ERIN LINDSAY DOMINGUEZ

MEDICARE: ERIN LINDSAY 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
1106S00000XBehavior Technician
2251S00000XCommunity/Behavioral Health Agency
3101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1164131520
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN LINDSAY DOMINGUEZ
Provider Business Mailing Address
First Line : 524 S 9TH AVE STE 103
Second Line :
City : CALDWELL
State : ID
Zip : 83605-5072
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 524 S 9TH AVE STE 103
Second Line :
City : CALDWELL
State : ID
Zip : 83605-5072
Country : US
Telephone Number : 208-454-3555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2022
Last Update Date : 08/27/2025

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Directions to “ ERIN LINDSAY DOMINGUEZ ” Practice Location

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