GEOFFREY DOMINCZAK (NPI# 1174068613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174068613 |
| Entity Type | Individual |
| Full Name | GEOFFREY DOMINCZAK |
| Credential | BCBA |
| Practice Address |
2814 Woodcliff Cir Se Grand Rapids MI 49506-3155 |
| Mailing Address |
7108 S Kanner Hwy Stuart FL 34997-7462 |
| Practice Telephone | 6163080323 |
| Mailing Telephone | 8558326727 |
| Enumeration Date | 2016-12-19 |
| Last Update Date | 2020-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 247200000X | Technician, Other | Technologists, Technicians & Other Technical Service Providers | ||
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| Street Address |
2814 WOODCLIFF CIR SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49506-3155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700144060 | Gabrielle Elena Bloom | Behavioral Analyst | 2814 Woodcliff Cir Se, Grand Rapids, MI 49506-3155 | 2012-04-24 |
| 1659972420 | Hannah Britton | Behavior Technician | 2814 Woodcliff Cir Se, Grand Rapids, MI 49506-3155 | 2020-11-06 |
| 1558962118 | Damaya Starr | Behavior Technician | 2814 Woodcliff Cir Se, Grand Rapids, MI 49506-3155 | 2020-11-02 |
| 1134729007 | Andrew David Speas | Behavior Technician | 2814 Woodcliff Cir Se, Grand Rapids, MI 49506-3155 | 2020-10-29 |
| 1265031116 | Amy Dunn | Behavior Technician | 2814 Woodcliff Cir Se, Grand Rapids, MI 49506-3155 | 2020-10-21 |
| 1063011476 | Rebecca Lange | Behavior Technician | 2814 Woodcliff Cir Se, Grand Rapids, MI 49506-3155 | 2020-10-19 |
| 1346848843 | Ashley N Craddock | Behavior Technician | 2814 Woodcliff Cir Se, Grand Rapids, MI 49506-3155 | 2020-10-15 |
| 1427656131 | Carrie Ann Scofield | Behavior Technician | 2814 Woodcliff Cir Se, Grand Rapids, MI 49506-3155 | 2020-10-14 |
| 1841898848 | Amy Jo Hamman | Behavior Technician | 2814 Woodcliff Cir Se, Grand Rapids, MI 49506-3155 | 2020-10-12 |
| 1144827619 | Lauren Elizabeth Meijer | Behavior Technician | 2814 Woodcliff Cir Se, Grand Rapids, MI 49506-3155 | 2020-10-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356954705 | Mckenna Shank | Technician | 1409 E Beltline Ave Se, Grand Rapids, MI 49506 | 2020-08-26 |
| 1750917969 | Meghan Elizabeth Southwell | Social Worker | Counseling Center of West Michigan, 360 East Beltline Ave Ne Suite 100, Grand Rapids, MI 49506 | 2020-03-19 |
| 1356876536 | Lisa Finkbeiner | Chiropractor | 1324 Lake Dr Se Ste 1, Grand Rapids, MI 49506 | 2017-04-26 |
| 1447622964 | Ashley Robinson | Rehabilitation Practitioner | 1490 East Beltline Ave, Grand Rapids, MI 49506 | 2015-10-23 |
| 1770951584 | Stuart Segal | Behavioral Analyst | 1415 Wealthy St Se Apt 312, Grand Rapids, MI 49506 | 2015-09-10 |
| 1922476373 | Elizabeth Taylor | Nurse Practitioner | 2255 Wealthy Dr., Grand Rapids, MI 49506 | 2015-09-02 |
| 1780066092 | Carole Walters Counseling | Social Worker | 959 Wealthy St. Se, Grand Rapids, MI 49506 | 2015-06-23 |
| 1053792697 | Rosemary F. Trimpe | Social Worker | 4255 Kalamazoo Se, Grand Rapids, MI 49506 | 2015-06-09 |
| 1164809919 | Gary James | Rehabilitation Practitioner | 1490 E. Beltline Se, Grand Rapids, MI 49506 | 2015-04-30 |
| 1275925315 | Paul Cole | Counselor | 1101 Ball Ave. .se., Grand Rapids, MI 49506 | 2015-02-26 |
| Find all providers in zip 49506 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051201 | Jennifer Joelle Jacobs | Counselor | 3760 Whispering Way Se Apt 204, Grand Rapids, MI 49546-7601 | 2020-10-22 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1528692779 | Tracy Norcross | Counselor | 2430 Camelot Ct Se, Grand Rapids, MI 49546-6001 | 2020-02-26 |
| 1487202743 | New Beginnings Counseling LLC | Counselor | 104 Ne 3rd St # 200h, Grand Rapids, MN 55744-2869 | 2019-08-29 |
| 1922652098 | Jason Powers | Counselor | 2033 43rd St Se Apt V8, Grand Rapids, MI 49508-8734 | 2019-07-28 |
| 1588225882 | Hope Restored Counseling Center LLC | Counselor | 2180 44th St Se Ste 302, Grand Rapids, MI 49508-5323 | 2019-06-26 |
| 1164089884 | Savanna Marie Vanderberg | Counselor | 1131 Worden St Se, Grand Rapids, MI 49507-1472 | 2019-05-29 |
| 1609432996 | Robb Kornoelje | Counselor | 221 Trowbridge St Ne Apt 208, Grand Rapids, MI 49503-1891 | 2019-05-13 |
| 1316423841 | Lorie Tensen | Counselor | 456 College Ave Se Apt 1, Grand Rapids, MI 49503-5373 | 2018-07-18 |
| 1548750524 | Katelyn Cable Ma LLP | Counselor | 5001 Plainfield Ave Se, Suite B, Grand Rapids, MI 49525-9349 | 2018-05-15 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49506 |
Please comment or provide details below to improve the information on GEOFFREY DOMINCZAK.
| 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.