Shanette Louise Dominick

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

LSSP017 Issued in LA

Practice address

702 Highland View Dr
Youngsville, LA 70592-6185

Phone

(337) 452-9795

NPI assigned

Nov 25, 2017

Last updated

Mar 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1285148551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 HIGHLAND VIEW DR",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705926185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 HIGHLAND VIEW DR",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705926185",
            "telephone_number": "337-452-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINICK",
        "first_name": "SHANETTE",
        "middle_name": "LOUISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-25",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "LA",
            "license": "LSSP017",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Delahoussaye, M.S., CCC-SLP
• Melissa Deshotels
• Lauren Elizabeth Dietz
• Sara Beth Doguet, M.D.
• Lane Domingues
• Tyson Dooley, DO
• Alicia Dore
• Carly Marie Dragich
• DRS Harmon &Thomas (A Professional Dental Corporation)
• Maria L Drummonds, LMT

• Counseling Psychologist in Youngsville, LA
• Providers in Youngsville, LA by specialty
• Counseling Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.