| Dr Aimee Blackham, PHD | |
|
622 Burgessville Rd, Ruston, LA 71270-5154 | |
| (318) 224-7223 | |
| (318) 414-1004 |
| Full Name | Dr Aimee Blackham |
|---|---|
| Gender | Female |
| Speciality | Clinical Psychologist |
| Experience | 13 Years |
| Location | 622 Burgessville Rd, Ruston, Louisiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114332038 | NPI | - | NPPES |
| 567123890 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 1373 (Louisiana) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Thinktrek Llc | 1951754951 | 9 |
| Entity Name | Thinktrek Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215415229 PECOS PAC ID: 1951754951 Enrollment ID: O20240125003776 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Aimee Blackham, PHD 3506 Evelyn Cir, Ruston, LA 71270-5323 Ph: (318) 243-0465 | Dr Aimee Blackham, PHD 622 Burgessville Rd, Ruston, LA 71270-5154 Ph: (318) 224-7223 |
Dr. Walter C Buboltz Jr., PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 622 Burgessville Rd, Ruston, LA 71270 Phone: 318-224-7223 Fax: 318-415-1004 | |
Mrs. Antoinette Kelly-clark, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 171 Water Tank Rd, Ruston, LA 71270 Phone: 318-548-7242 | |
Dr. David Lanson Wheeler, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1401 Ezell Street, Ruston, LA 71270 Phone: 318-251-3126 | |
Eric Deemer, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2419 Redwood St, Ruston, LA 71270 Phone: 318-257-3659 |