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Contact Information

DOMINIQUE BALDERAS, LPC
W317S3439 STATE ROAD 83 APT B
WAUKESHA, WI53189-9428
 Phone: 414-759-5247
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mental Health

101YM0800X
 

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for DOMINIQUE BALDERAS · (Female)

NPI Number 1245984996
Status Active
Credentials LPC (Licensed Professional Counselor)
Entity Individual
Enumeration date 02/10/2022
Last updated 04/01/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • WI License # 11434125
  • WI License # 19426
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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