Individual provider · Type 1 NPI

Carroll D. Blackledge, MA, P-LPC

Professional Counselor · Jackson, MS

NPI number 1295292274 Active

Practice location

4500 I 55 N Ste 208
Jackson, MS 39211-5931

Call (601) 405-7440 Map

Mailing address

107 Laurel Glen Ct
Madison, MS 39110-7395

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XP-0512 (MS)

Professional Counselor: Definition to come...

2 other providers at this address

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About NPI 1295292274

Carroll D. Blackledge, MA, P-LPC's National Provider Identifier is 1295292274, issued on Feb 26, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Jackson, MS. The record was last updated on Feb 26, 2019.