Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mariah Sharelle Domino, BSMA

Individual provider Mental Health Counselor · NPI 1568908119

Mariah Sharelle Domino, BSMA is a Mental Health Counselor in Baton Rouge, Louisiana. Licensed in Louisiana. Registered with an NPI since 2017.

Licensed in
LA
In the registry since
2017
Specialties on file
3

Practice location Address checks out

8211 Summa Ave Ste F
Baton Rouge, LA 70809
Phone: (225) 761-1970
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X
Mental Health Counselor Taxonomy 101YM0800X · Licence LPC7778 (LA)
Case Manager/Care Coordinator Taxonomy 171M00000X

Record details

NPI number1568908119
Entity typeIndividual (Type 1)
GenderFemale
Credentials BSMA
Sole proprietorNo
NPI enumeratedJanuary 6, 2017
Last updated in NPPESMarch 22, 2023
Certification dateMarch 22, 2023

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