MAYA DOMOTO LPC
NPI 1477852150
Social Worker - Clinical in Charlotte, NC
NPI Status: Active since March 21, 2011
Contact Information
5200 PARK RD STE 218B
CHARLOTTE, NC
ZIP 28209
Phone: (866) 700-1606
Fax: (866) 338-5921
- Individual
- Female
- Social Worker
- Clinical
- Accepts Insurance
- PECOS Enrolled
About MAYA DOMOTO
This page provides the complete NPI Profile along with additional information for Maya Domoto, a provider established in Charlotte, North Carolina with a medical specialization in Social Worker, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1477852150 assigned on March 2011. The practitioner's primary taxonomy code is 1041C0700X with license number C012094 (NC). The provider is registered as an individual and her NPI record was last updated 6 years ago.
- NPI
- 1477852150
- Provider Name
- MAYA DOMOTO LPC
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 5200 PARK RD STE 218B CHARLOTTE, NC 28209
- Location Phone
- (866) 700-1606
- Location Fax
- (866) 338-5921
- Mailing Address
- 7711 MCCARRON WAY CHARLOTTE, NC 28215
- Mailing Phone
- (408) 477-6146
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-21-2011
- Last Update Date
- 11-29-2019
- Code Navigator
A clinical social worker like Maya Domoto is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Social Worker Clinical
- Taxonomy Code
- 1041C0700X
- Type
- Behavioral Health & Social Service Providers
- License No.
- C012094
- License State
- NC
- Taxonomy Description
- A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 104100000X | Behavioral Health & Social Service Providers | Social Worker | 67137 (CA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Bronze Standard | Nationwide Doctors - PPO
- Blue Advantage Gold Premier | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Gold Standard | Nationwide Doctors - PPO
- Blue Advantage Silver Choice | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Silver Standard | Nationwide Doctors - PPO
- Blue Care Bronze Standard | Statewide Doctors - HMO
- Blue Care Gold Standard | Statewide Doctors - HMO
- Blue Care Silver Standard | Statewide Doctors - HMO
- Blue Value Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | Limited Statewide Doctors - POS
- Blue Value Bronze Complete | $60 PCP | $20 Tier 1 Rx | Limited Statewide Doctors - POS
- Blue Value Bronze Standard | Limited Statewide Doctors - POS
- Blue Value Gold Premier | 3 Free PCP | $10 Tier 1 Rx | Limited Statewide Doctors - POS
- Blue Value Gold Standard | Limited Statewide Doctors - POS
- Blue Value Silver Choice | 3 Free PCP | $15 Tier 1 Rx | Limited Statewide Doctors - POS
- Blue Value Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Limited Statewide Doctors - POS
- Blue Value Silver Standard | Limited Statewide Doctors - POS
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Bronze Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Maya Domoto is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 28209 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is NA
- Average New Patient Price $0
- Minimum New Patient Price $54.12
- Maximum New Patient Price $165.09
- Average New Patient Copayment $0
- Minimum New Patient Copayment $13.53
- Maximum New Patient Copayment $41.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $67.72
- Minimum Established Patient Price $17.21
- Maximum Established Patient Price $134.61
- Average Established Patient Copayment $16.93
- Minimum Established Patient Copayment $4.3
- Maximum Established Patient Copayment $33.65
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Reviews for MAYA DOMOTO LPC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 7 | 7 | 8 | 5 | 2 | 1 | 5 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 14 | 7 | 16 | 5 | 4 | 1 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 4 + 7 + 1 + 6 + 5 + 4 + 1 + 1 + 0 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1477852150 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1861857088 | MS. TAMATHA S. FORTUNE LPCA, NCC, CCMC Individual | Counselor (Professional) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1619468501 | AISHAH RENEE WHITEHEAD LCSWA Individual | Social Worker (Clinical) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1659846954 | RACHEL MILBOURN LCSWA Individual | Social Worker (Clinical) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1558887570 | TERRITA L CHAMBERS LPC Individual | Counselor (Mental Health) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1174016422 | TIFFANY VILESE MCCULLOUGH LMFTA Individual | Marriage & Family Therapist | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1538705801 | SHAUNTAE RENA GRIFFIN LCSWA Individual | Social Worker (Clinical) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1386275089 | BRIANNA D FRINK LCSWA Individual | Social Worker (Clinical) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1740785815 | MATLYN HOGAN TRESIERRA LCSWA Individual | Social Worker (Clinical) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1366937872 | TANIKA EVETTE BARBER LCSW Individual | Social Worker (Clinical) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1598123689 | DANIELLE MARTIN LCSWA Individual | Social Worker (Clinical) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1346795846 | DEANGELO DESHAUN BROOKS MS, LPCA Individual | Counselor (Professional) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1003318577 | LINDSEY YVETTE DONATIEN LCMHC Individual | Counselor (Professional) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1730707027 | TALIA SCOTT LCMHCA Individual | Counselor (Professional) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1666 |
| 1447899141 | DANIELLE C WILLIS LCSWA Individual | Social Worker (Clinical) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (667) 001-6068 |
| 1194311282 | AGHASHIYAH AL'HAQQAH MUHAMMAD WILSON LCSW-A Individual | Social Worker (Clinical) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1972933620 | DINESHA BAKER Individual | Counselor (Professional) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1861054439 | KRISTA LUGIA STUTTS MSW, LCSW-A Individual | Social Worker (Clinical) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1124363718 | SHASTA GABRIELLE STATEN MED, LPC Individual | Counselor (Professional) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1558939082 | STEVA CHAMLAS BURNETTE LCSW-A Individual | Social Worker (Clinical) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
| 1922670413 | LAYLA ASHLEY HICKS LCSWA Individual | Social Worker (Clinical) | 5200 PARK RD STE 218B CHARLOTTE, NC 28209 (866) 700-1606 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1477852150, enumerated in the NPI registry as an "individual" on March 21, 2011
The provider is located at 5200 Park Rd Ste 218b Charlotte, Nc 28209 and the phone number is (866) 700-1606
The provider's speciality is Social Worker with taxonomy code 1041C0700X with a focus in Clinical
The provider might be accepting Accepts: Blue Cross and Blue Shield of NC and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
Medicare beneficiaries should expect a typical cost of $0 with an average copayment of $0 for new patient appointments. Established patients should expect a typical charge of $67.72 and an average copayment of 16.93. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on March 21, 2011. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.