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Mr. Peter Russell Blackman JR.
Mental Health Counselor in Bunkie, Louisiana
NPI 1609233907

Peter Russell Blackman JR. is a Mental Health Counselor based in Mansura, LA and is specialized in Mental Health. Peter Russell Blackman JR. practices in Bunkie, LA. The NPI Number for Peter Russell Blackman JR. is 1609233907 and holds a License No. 1544761 (Louisiana).

The current practice location address for Peter Russell Blackman JR. is 1140 Shirley Rd, Bunkie, LA and can be reached out via phone at 318-346-8001 and via fax at 318-346-8005.

Location: 1140 Shirley Rd, Bunkie, LA, 71350-0205
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1609233907
Provider Name
Peter Russell Blackman JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
1140 Shirley Rd, Bunkie, LA, 71350-0205
Phone Number
318-346-8001
Fax Number
318-346-8005
Provider Enumeration Date
01/19/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1544761 05 LA
institution
Provider Business Practice Location Address Details
Address
1140 Shirley Rd
City
Bunkie
State
Louisiana
Zip
71322-1545
Phone Number
318-346-8001
Fax Number
318-346-8005
person
Provider Business Mailing Address Details
Address
1140 Shirley Rd
City
Bunkie
State
Louisiana
Zip
71322-1545
Phone Number
318-346-8001
Fax Number
318-346-8005
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
1544761 (Louisiana)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
1544761 (Louisiana)
Definition
Definition to come...
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