Individual
COURTNEY BRIANN BLACKLEDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHCA
Contact information
Practice address
110 PREMIERE PLZ, WHITEVILLE, NC 28472-2522
(910) 524-3812
(910) 202-9966
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 343-0145
(910) 202-9966
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A15842
NC
101YP2500X
Professional Counselor
A15842
NC
Other
Enumeration date
07/20/2020
Last updated
10/27/2020
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