Jeanne Marie Blakeslee, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP139257 Issued in TX

Practice address

1100 E Southlake Blvd Ste 300
Southlake, TX 76092-6350

Phone

(178) 873-0595

Fax

(817) 873-0596

NPI assigned

Oct 3, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.jeanneblakeslee@136732.advancedmd-direct.com

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.

• Progressive Behavioral Health, PLLC

  • Mental Health Counselor
  • Friendswood, TX
  • NPI 1659567238

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1750369203
  Medicare reassignment NPD
• Emh Central NW Austin Clinic PLLC

  • Professional Counselor
  • Austin, TX
  • NPI 1932834371
  Medicare reassignment NPD
• Psych Dimensions Inc

  • Psychiatry Physician
  • Georgetown, TX
  • NPI 1538534086
  Medicare reassignment
• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1083472062
  NPD
• Molina Psychiatric Associates PA

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1831756303
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1265907414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W COOPERATIVE WAY",
            "address_2": "STE 110",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786268209",
            "telephone_number": "178-873-0595",
            "fax_number": "817-873-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E SOUTHLAKE BLVD STE 300",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926350",
            "telephone_number": "178-873-0595",
            "fax_number": "817-873-0596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 S Capital Of Texas Hwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787466544",
            "country_code": "US",
            "telephone_number": "844-824-8775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 7th Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761042733",
            "country_code": "US",
            "telephone_number": "682-885-1050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKESLEE",
        "first_name": "JEANNE",
        "middle_name": "MARIE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP139257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "AP139257",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Nicole Birdwell
• Samantha Birtalan
• Cameron Michelle Bisbey, MPT, PT
• Lisa Bishop, OD
• Jeff Black, MA, LPC
• Angelica Bledsoe, RBT
• Bloom Primary TX II, PA
• Blue Ocean Health Services LLC
• Blue Ridge Medical Solutions LLC
• Ashley Bobb

• Psychiatric/Mental Health Nurse Practitioner in Southlake, TX
• Providers in Southlake, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.