Individual provider Active NPI

Brittany Michelle Domingue, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1508745258
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
205177 Issued in LA
Practice address
1921 Dulles Dr
Lafayette, LA 70506-2716
Phone
(337) 579-5777
NPI assigned
Aug 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 205177 LA Primary

Addresses

Primary practice location

1921 Dulles Dr
Lafayette, LA 70506-2716

Mailing address

608 Katherine St
Jeanerette, LA 70544-4701
Phone (337) 371-2995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251118003075 LA Practitioner - Nurse Practitioner 9830680750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kite Clinic LLCGroup PAC ID 7315338340, 6 clinicians

Practice addresses (Care Compare)

1921 Dulles Dr
Lafayette, LA 70506-2716
Phone 3375795777106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
205177LAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kite Clinic LLC Psychiatric/Mental Health CurrentSince Nov 3, 2025 Accepting new patients
Holistic Behavioral Health Services of Louisiana PastSince Sep 1, 2025 Accepting new patients

Locations

1921 Dulles Dr
Lafayette, LA 70506
Phone (337) 223-9487

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1508745258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 KATHERINE ST",
            "city": "JEANERETTE",
            "state": "LA",
            "postal_code": "705444701",
            "telephone_number": "337-371-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 DULLES DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705062716",
            "telephone_number": "337-579-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUE",
        "first_name": "BRITTANY",
        "middle_name": "MICHELLE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "205177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.