Walisha M. Blackmore, M. ED., LPC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

15296 Issued in TX

Practice address

2100 19TH St
Port Arthur, TX 77640-3859

Phone

(409) 344-2790

NPI assigned

Jan 8, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walisha M. Blackmore M.Ed., LPC

  • Counselor
  • Port Arthur, TX
  • NPI 1649674219
  NPD (past) Authorized official
• M.K. Hamza PH.D., P.a.

  • Clinical Psychologist
  • Nederland, TX
  • NPI 1346434750
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1992853063",
    "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",
            "telephone_number": "409-344-2790"
        },
        {
            "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": [
        {
            "address_1": "2512 Nall St",
            "address_purpose": "LOCATION",
            "city": "Port Neches",
            "state": "TX",
            "postal_code": "776514706",
            "country_code": "US",
            "telephone_number": "409-727-5785",
            "fax_number": "409-729-0465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKMORE",
        "first_name": "WALISHA",
        "middle_name": "M.",
        "credential": "M. ED., LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "15296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0283715-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.