Provider Demographics
NPI:1104301043
Name:BLEDSOE-LINK, NANCY JANE (MA, LPC, LCDC)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JANE
Last Name:BLEDSOE-LINK
Suffix:
Gender:F
Credentials:MA, LPC, LCDC
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:JANE
Other - Last Name:BLEDSOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:1480 JUNIPER LN
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2840
Mailing Address - Country:US
Mailing Address - Phone:972-951-7000
Mailing Address - Fax:
Practice Address - Street 1:2560 CENTRAL PARK AVE STE 200
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1566
Practice Address - Country:US
Practice Address - Phone:940-289-4569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-26
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74740101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional