Active NPI
Courtney Bledsoe
- Professional Counselor
- Shreveport, LA
National Provider Identifier
1114387388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6903
- Practice address
- 2620 Centenary Blvd Ste 312
Shreveport, LA 71104-3358 - Phone
- (318) 681-9935
- NPI assigned
- Mar 2, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6903 | LA | Primary |
| Social Worker | 104100000X | LA |
Addresses
Primary practice location
2620 Centenary Blvd Ste 312
Shreveport, LA 71104-3358
Mailing address
745 Kingridge PL
Shreveport, LA 71108-6017
Phone (318) 573-0872
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6903 | LA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700524800000",
"number": "1114387388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "745 KINGRIDGE PL",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711086017",
"telephone_number": "318-573-0872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2620 CENTENARY BLVD STE 312",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711043358",
"telephone_number": "318-681-9935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLEDSOE",
"first_name": "COURTNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-02",
"last_updated": "2023-11-21",
"certification_date": "2023-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "6903",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "LA",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.