Organization Active NPI

Declouet Mental Health Solutions, LLC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Lafayette, LA
National Provider Identifier
1366011884
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
Legal business name
DECLOUET MENTAL HEALTH SOLUTIONS, LLC
Practice address
302 La Rue France Ste 202
Lafayette, LA 70508-3133
Phone
(337) 534-0971
Fax
(337) 534-0974
NPI assigned
Jun 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Authorized official

Name
Matthew Alexander Declouet, PMHNPNPI 1518342310
Title
Owner
Phone
(337) 280-0441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SP0809X Primary

Addresses

Primary practice location

302 La Rue France Ste 202
Lafayette, LA 70508-3133

Mailing address

302 La Rue France Ste 202
Lafayette, LA 70508-3133
Phone (337) 534-0971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250805000377 LA Part B Supplier - Clinic/Group Practice 8426450313 Receives reassigned benefits from 5 practitioners
Practice locations: Lafayette, LA

National Provider Directory

National Provider Directory

Locations

302 La Rue France
Ste 200
Lafayette, LA 70508
Phone (337) 534-0121

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1366011884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 LA RUE FRANCE STE 202",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083133",
            "telephone_number": "337-534-0971",
            "fax_number": "337-534-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 LA RUE FRANCE STE 202",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083133",
            "telephone_number": "337-534-0971",
            "fax_number": "337-534-0974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECLOUET MENTAL HEALTH SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-19",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "DECLOUET",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-280-0441",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.