Individual provider Active NPI

Linda Carol Blandshaw, LCMHC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1629458187
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11214 Issued in NC
Practice address
6849 Fairview Rd Ste 702
Charlotte, NC 28210-3393
Phone
(980) 308-4500
Fax
(980) 458-6037
NPI assigned
May 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 11214 NC
Mental Health Counselor 101YM0800X 11214 NC Primary

Addresses

Primary practice location

6849 Fairview Rd Ste 702
Charlotte, NC 28210-3393

Mailing address

6849 Fairview Rd Ste 702
Charlotte, NC 28210-3393
Phone (980) 308-4500

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

LicenseStateTypeSpecialty
11214NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Jenkins Creative Counseling Center, PLLC CurrentSince Nov 10, 2024 Accepting new patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients

Locations

6849 Fairview Rd
Ste 702
Charlotte, NC 28210
Phone (980) 308-4500

Interoperability endpoints

  • Direct secure messaging: lindablandshaw@tdh.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1629458187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6849 FAIRVIEW RD STE 702",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103393",
            "telephone_number": "980-308-4500",
            "fax_number": "980-458-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6849 FAIRVIEW RD STE 702",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103393",
            "telephone_number": "980-308-4500",
            "fax_number": "980-458-6037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANDSHAW",
        "first_name": "LINDA",
        "middle_name": "CAROL",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-31",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "11214",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "11214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.