=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780527622
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COURTNEY BLEDSOE LCSW PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/14/2026
-----------------------------------------------------
Last Update Date | 04/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 801 SOUTH BLVD STE 7
-----------------------------------------------------
City | OAK PARK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60302-2855
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-405-9225
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1037 S HARVEY AVE
-----------------------------------------------------
City | OAK PARK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60304-2131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-405-9225
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | COURTNEY BLEDSOE
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 708-405-9225
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------