Individual provider Active NPI

Aimee Blackham, PHD

  • Counseling Psychologist
  • Ruston, LA
National Provider Identifier
1114332038
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
1373 Issued in LA
Practice address
622 Burgessville Rd
Ruston, LA 71270-5154
Phone
(318) 224-7223
Fax
(318) 414-1004
NPI assigned
Jun 30, 2014
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 1373 LA Primary

Addresses

Primary practice location

622 Burgessville Rd
Ruston, LA 71270-5154

Mailing address

2804 Lakeview Dr
Ruston, LA 71270-5254
Phone (318) 243-0465

Other identifiers 1

IdentifierTypeStateIssuer
567123890MedicaidLA

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109004863 LA Practitioner - Clinical Psychologist 3375994809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thinktrek LLCGroup PAC ID 1951754951, 9 clinicians

Practice addresses (Care Compare)

622 Burgessville Rd
Ruston, LA 71270-5154
Phone (318) 224-7223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Thinktrek LLC CurrentSince Jan 1, 2024 Accepting new patients
Lincoln Counseling Past Accepting new patients

Locations

3018 Old Minden Rd
Ste 1200
Bossier City, LA 71112
Phone (318) 224-7223

206 E Reynolds Dr
Ste F2
Ruston, LA 71270
Phone (318) 224-7223

622 Burgessville Rd
Ruston, LA 71270
Phone (318) 224-7223

Networks

  • LA PPO C-SNP

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, 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": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1114332038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 LAKEVIEW DR",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705254",
            "telephone_number": "318-243-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 BURGESSVILLE RD",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705154",
            "telephone_number": "318-224-7223",
            "fax_number": "318-414-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKHAM",
        "first_name": "AIMEE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "LA",
            "license": "1373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "567123890",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruston, LA

Sources for this page

Verify at the official NPI Registry.