Individual provider Active NPI

Dominique Michellee Rougeau, MA, BCBA, LBA

  • Behavior Analyst
  • Lake Charles, LA
National Provider Identifier
1790259463
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
L-344 Issued in LA
Practice address
1905 Tybee LN
Lake Charles, LA 70605-4172
Phone
(337) 240-8162
NPI assigned
Jan 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Behavior Analyst 103K00000X L-344 LA Primary

Addresses

Primary practice location

1905 Tybee LN
Lake Charles, LA 70605-4172

Mailing address

18840 NW Rock Creek Cir Apt 285
Portland, OR 97229-7204
Phone (337) 292-5906

Other practice location 1

1924 Southwood Dr
Lake Charles, LA 70605-4131
Phone (337) 602-8884

Other identifiers 1

IdentifierTypeStateIssuer
3647681MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
L-344LAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Project Odyssey ABA, LLC Behavior Analyst CurrentSince Feb 1, 2022 Accepting new patients
Renaissance Solutions, LLC Behavior Analyst PastSince Apr 13, 2025 Accepting new patients
Mental Connections of Southwest LLC Mental Health PastSince Apr 11, 2021 Accepting new patients

Organizations & group practices 3

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": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1790259463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18840 NW ROCK CREEK CIR APT 285",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972297204",
            "telephone_number": "337-292-5906",
            "fax_number": "618-418-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 TYBEE LN",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054172",
            "telephone_number": "337-240-8162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1924 Southwood Dr",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706054131",
            "country_code": "US",
            "telephone_number": "337-602-8884",
            "fax_number": "337-240-8163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUGEAU",
        "first_name": "DOMINIQUE",
        "middle_name": "MICHELLEE",
        "credential": "MA, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "LA",
            "license": "L-344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3647681",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.