NPIMap

Organization Active NPI

Walisha M. Blackmore M.Ed., LPC

  • Counselor
  • Port Arthur, TX
National Provider Identifier
1649674219
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
15296 Issued in TX
Legal business name
WALISHA M. BLACKMORE M.ED., LPC
Practice address
2100 19TH St
Port Arthur, TX 77640-3859
Phone
(409) 344-2790
NPI assigned
Oct 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

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

Authorized official

Name
Walisha Blackmore, LPCNPI 1992853063
Title
Licensed Professional Counselor
Phone
(409) 344-2790

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X 15296 TX Primary

Addresses

Primary practice location

2100 19TH St
Port Arthur, TX 77640-3859

Mailing address

2100 19TH St
Port Arthur, TX 77640-3859

Other identifiers 1

IdentifierTypeStateIssuer
028371503MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412899200000",
    "number": "1649674219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 19TH ST",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776403859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 19TH ST",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776403859",
            "telephone_number": "409-344-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALISHA M. BLACKMORE M.ED., LPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-10",
        "last_updated": "2014-10-10",
        "status": "A",
        "authorized_official_last_name": "BLACKMORE",
        "authorized_official_first_name": "WALISHA",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "409-344-2790",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "TX",
            "license": "15296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028371503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.