Jenifer Blackmore
Individual provider Active NPI Counselor · Leesville, LA
NPI 1992166375 · NPPES record last updated Mar 14, 2016
Key facts
- NPI
- 1992166375
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 1808 S 5TH St
Leesville, LA 71446-5308 - Phone
- (337) 238-4350
- NPI assigned
- Mar 14, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehab Services of Cenla | Past | Accepting new patients | |
| Rehab Services of Cenla | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
1808 S 5TH St
Leesville, LA 71446-5308
Mailing address
2525 Youree Dr
Shreveport, LA 71104-3671
Phone (318) 605-0804
Other providers in Leesville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2016. 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.