Active NPI
Boris Trent Bartley II, PLPC
- Professional Counselor
- Shreveport, LA
National Provider Identifier
1720574452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 10902
- 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, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 10902 | LA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabilitation Services of Northwest Louisiana, LLC | Past | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Shreveport, LA
- NPI 1427137074
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.