Provider Demographics
NPI:1871276998
Name:DOMINATING THERAPEUTIC SERVICES, PLLC
Entity type:Organization
Organization Name:DOMINATING THERAPEUTIC SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:SANDREA
Authorized Official - Last Name:ROACH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,LCSW,LCAS,CCSOTS
Authorized Official - Phone:252-531-6226
Mailing Address - Street 1:418 FARMINGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8786
Mailing Address - Country:US
Mailing Address - Phone:252-531-6226
Mailing Address - Fax:
Practice Address - Street 1:2428 CHARLES BLVD STE 102
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-6052
Practice Address - Country:US
Practice Address - Phone:919-882-9289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty