Active NPI
Jennifer Blondeau, M.ED, LPC, NCC
- Professional Counselor
- Newnan, GA
National Provider Identifier
1154773752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3574
- Practice address
- 59 Hospital Rd
Newnan, GA 30263-1209 - Phone
- (678) 423-4610
- NPI assigned
- Jul 7, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3574 | AL | Primary |
Addresses
Primary practice location
59 Hospital Rd
Newnan, GA 30263-1209
Mailing address
1 Wrightsburg CT
Senoia, GA 30276-3410
Phone (770) 337-7813
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3574 | AL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lighthouse Counseling PC | Professional | 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 and National Provider Directory roles.
-
- Professional Counselor
- Newnan, GA
- NPI 1205961232
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522022400000",
"number": "1154773752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 WRIGHTSBURG CT",
"city": "SENOIA",
"state": "GA",
"postal_code": "302763410",
"telephone_number": "770-337-7813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59 HOSPITAL RD",
"city": "NEWNAN",
"state": "GA",
"postal_code": "302631209",
"telephone_number": "678-423-4610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLONDEAU",
"first_name": "JENNIFER",
"name_prefix": "Ms.",
"credential": "M.ED, LPC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-07",
"last_updated": "2018-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AL",
"license": "3574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newnan, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.