Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Dereik Lance Domerese, LCSW

Clinical Social Worker in Lees Summit, MO · enumerated 2017 · practices at Mind Shield and Sword Therapy, LLC.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1760927586

Verified

See something wrong? Report a correction

Registry record

Entity type Individual (Type 1)

Name Dereik Lance Domerese

Credential LCSW

Sex Male

Practice address 905 Ne Rice Rd Ste B, Lees Summit, MO, 64086

Phone (816) 223-8522

Enumeration date Jan 3, 2017

Last updated in NPPES Jun 15, 2022

Taxonomy & licenses

1041C0700X Clinical Social Worker Behavioral Health & Social Service Providers · License 10198 (KS) Secondary

1041C0700X Clinical Social Worker Behavioral Health & Social Service Providers · License 2016034259 (MO) Primary

LCSW · Licensed Clinical Social Worker: A social worker licensed for clinical practice including mental-health therapy. About the LCSW credential

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

How do I verify Dereik Domerese's NPI record?

Cross-check NPI 1760927586 against the official CMS registry at npiregistry.cms.hhs.gov. This page mirrors the same public NPPES data with a monthly snapshot.

Is NPI 1760927586 active?

Yes, as of the latest NPPES snapshot, NPI 1760927586 is active (record last updated 2022-06-15).

Other providers at this practice address

Browse all →

Mind Shield and Sword Therapy, LLC Clinical Social Worker · Lees Summit, MO NPI 1467181024

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-06-15.