Active NPI
Aimee D. Dominique, LCSW
- Clinical Social Worker
- Lafayette, LA
National Provider Identifier
1992764799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2895
- Practice address
- 143 Ridgeway Dr
Suite 207
Lafayette, LA 70503-3414 - Phone
- (337) 257-0883
- NPI assigned
- Mar 21, 2006
- Last updated
- Dec 3, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2895 | LA | Primary |
Addresses
Primary practice location
143 Ridgeway Dr
Suite 207
Lafayette, LA 70503-3414
Mailing address
305 Raywood Dr
Lafayette, LA 70503-5057
Phone (337) 257-0883
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2895 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Timnath Corporation | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228262400000",
"number": "1992764799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 RAYWOOD DR",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705035057",
"telephone_number": "337-257-0883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "143 RIDGEWAY DR",
"address_2": "SUITE 207",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705033414",
"telephone_number": "337-257-0883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINIQUE",
"first_name": "AIMEE",
"middle_name": "D.",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-21",
"last_updated": "2008-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "2895",
"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 Dec 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.