DR. SAMANTHA DOMINGO (NPI# 1013336510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013336510 |
| Entity Type | Individual |
| Full Name | DR. SAMANTHA DOMINGO |
| Credential | PSY.D. |
| Practice Address |
3521 Nw Samaritan Dr Ste 201 Corvallis OR 97330-4744 |
| Mailing Address |
Po Box 1189 Corvallis OR 97339-1189 |
| Practice Telephone | 5417685140 |
| Enumeration Date | 2014-04-11 |
| Last Update Date | 2020-11-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 2791 | OR | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
3521 NW SAMARITAN DR STE 201 |
| City | CORVALLIS |
| State | OR |
| Zip Code | 97330-4744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659355899 | Samantha Rao Shah | Internal Medicine | 3521 Nw Samaritan Dr Ste 201, Corvallis, OR 97330-4744 | 2005-12-01 |
| 1578195087 | Rosemary Swift Schairer | Registered Nurse | 3521 Nw Samaritan Dr Ste 201, Corvallis, OR 97330-4744 | 2020-02-12 |
| 1790206100 | Craig Ellis Brauer | Pharmacist | 3521 Nw Samaritan Dr Ste 201, Corvallis, OR 97330-4744 | 2017-07-06 |
| 1487041687 | Carly Ann Mayumi Crider | Internal Medicine | 3521 Nw Samaritan Dr Ste 201, Corvallis, OR 97330-4744 | 2015-04-25 |
| 1629463237 | Anne Marie Collum | Internal Medicine | 3521 Nw Samaritan Dr Ste 201, Corvallis, OR 97330-4744 | 2015-03-31 |
| 1023438231 | Gwyn Mahony | Family Medicine | 3521 Nw Samaritan Dr Ste 201, Corvallis, OR 97330-4744 | 2014-04-27 |
| 1437496544 | Jacquelyn J Sinclair | Registered Nurse | 3521 Nw Samaritan Dr Ste 201, Corvallis, OR 97330-4744 | 2013-01-09 |
| 1710252473 | Andree Elizabeth Volin | Social Worker | 3521 Nw Samaritan Dr Ste 201, Corvallis, OR 97330-4744 | 2012-03-14 |
| 1598051666 | Tracy Lee Hume | Internal Medicine | 3521 Nw Samaritan Dr Ste 201, Corvallis, OR 97330-4744 | 2011-06-27 |
| 1003149576 | Michael J. Bachop | Psychologist | 3521 Nw Samaritan Dr Ste 201, Corvallis, OR 97330-4744 | 2009-09-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754912 | Miya Claborn | Counselor | 4495 Se Hwy 20, Corvallis, OR 97330 | 2020-06-09 |
| 1548889017 | Greydi Olvera | Counselor | Childrens Farm Home 4455 Ne Hwy 20, Corvallius, OR 97330 | 2020-04-14 |
| 1053953992 | Andie Marie Gaipo | Counselor | 4455 Ne Hwy 20 - Children's Farm Home, Corvallis, OR 97330 | 2019-10-11 |
| 1740847177 | Stephen Jack Eccles | Behavior Technician | Trillium Children's Farm Home, 4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-05-21 |
| 1750944815 | Tiffany Rene Flinchpaugh | Counselor | Children's Farm Home 4455 Hwy 20, Corvallis, OR 97330 | 2019-04-15 |
| 1679035455 | Isaiah Mile Cassidy | Counselor | Children's Farm Home-4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-04-02 |
| 1982168399 | Haylee Cramblit | Counselor | Children's Farm Home 4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-01-30 |
| 1457835365 | Ashley Alyn Couch | Counselor | 4455 Hwy 20 Corvallis 97330, Corvallis, OR 97330 | 2018-09-18 |
| 1104318898 | Megan Gerding | Technician, Other | 996 Nw Circle Blvd Suite 103, Corvallis, OR 97330 | 2018-05-30 |
| 1700377108 | Pacific Hearing Services | Audiologist | 975 Nw Spruce Ave, Suite #101, Corvallis, OR 97330 | 2018-05-22 |
| Find all providers in zip 97330 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198315 | Emi Sumida Brown | Psychologist | 993 Nw Circle Blvd Ste A, Corvallis, OR 97330-1408 | 2019-11-14 |
| 1407340318 | Homespun Counseling, LLC | Psychologist | 33055 Se Peoria Rd, Corvallis, OR 97333-2529 | 2018-06-15 |
| 1659685220 | Seth David Bernstein | Psychologist | 344 Nw 6th Street, Corvallis, OR 97330 | 2010-08-05 |
| 1801001151 | Harry (sam) Wells Sappington IIi | Psychologist | 260 Sw Madison Ave., Suite #107, Corvallis, OR 97333-4728 | 2007-05-11 |
| 1992885701 | Erica Dianne Prince | Psychologist | 223 Sw 8th St, Corvallis, OR 97333-4544 | 2006-10-16 |
| 1033202940 | Julie A Evans Watkins | Psychologist | 260 Sw Madison Ave Ste 116, Corvallis, OR 97333-4739 | 2006-10-02 |
| 1790884690 | Timothy Joseph Catlow | Psychologist | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2006-09-21 |
| 1316994643 | Douglas A. Smyth | Psychologist | 700 Nw 3rd St, Corvallis, OR 97330-6202 | 2006-05-30 |
| 1124079066 | Julien J Guillaumot | Psychologist | 408 Sw Monroe Ave Ste M210d, Corvallis, OR 97333-7228 | 2006-05-15 |
| 1952351454 | Carol A. Carver | Psychologist | 2380 Nw Kings Blvd, Suite 102, Corvallis, OR 97330-3978 | 2006-05-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.