Individual provider Active NPI

Boris Trent Bartley II, PLPC

  • Professional Counselor
  • Shreveport, LA
National Provider Identifier
1720574452
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10902 Issued in LA
Practice address
2924 Knight St Ste 436
Shreveport, LA 71105-2431
Phone
(318) 606-4413
Fax
(318) 425-9030
NPI assigned
Jul 5, 2018
Last updated
Oct 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 10902 LA Primary

Addresses

Primary practice location

2924 Knight St Ste 436
Shreveport, LA 71105-2431

Mailing address

4141 Courtland Way
Benton, LA 71006-9723
Phone (318) 294-7569

Other practice location 1

4141 Courtland Way
Benton, LA 71006-9723
Phone (318) 464-7186

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
10902LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Services of Northwest Louisiana, LLC PastSince Jun 25, 2023 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1720574452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 COURTLAND WAY",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710069723",
            "telephone_number": "318-294-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 KNIGHT ST STE 436",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052431",
            "telephone_number": "318-606-4413",
            "fax_number": "318-425-9030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4141 Courtland Way",
            "address_purpose": "LOCATION",
            "city": "Benton",
            "state": "LA",
            "postal_code": "710069723",
            "country_code": "US",
            "telephone_number": "318-464-7186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARTLEY",
        "first_name": "BORIS",
        "middle_name": "TRENT",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PLPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-05",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "10902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.