Courtney Briann Blackledge, LCMHCA
Individual provider Active NPI Mental Health Counselor · Whiteville, NC
NPI 1629686381 · NPPES record last updated Oct 27, 2020
Key facts
- NPI
- 1629686381
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- A15842 (NC)
- Practice address
- 110 Premiere PLZ
Whiteville, NC 28472-2522 - Phone
- (910) 524-3812
- Fax
- (910) 202-9966
- NPI assigned
- Jul 20, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A15842 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Horizons Center Inc. | Mental Health | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | A15842 | NC | Yes |
| Professional Counselor |
101YP2500X | A15842 | NC |
Addresses
Primary practice location
110 Premiere PLZ
Whiteville, NC 28472-2522
Mailing address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145
Other practice location 1
209 Peanut Plant Rd
Elizabethtown, NC 28337-2833
Phone (910) 343-0145
Other providers in Whiteville, NC
- Devoria Keaton Berry
- Richard Garth Berry
- Better Primary Care and Wellness
- Elizabeth Erin Bickell
- Grant Bishop
- Tonia Blackwell
- Viola Elizabeth Blackwell
- Bladen Healthcare LLC
- Tavares Bostic
- James E Boston
All providers in Whiteville, NC · Mental Health Counselor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.