MR. JEFF BLACK MA LPC NPI 1548713217

NPI Information

NPI: 1548713217
Provider Name: MR. JEFF BLACK, MA, LPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
578 N KIMBALL AVE
SUITE 130
SOUTHLAKE, TX
ZIP 76092
Phone: (817) 601-5877
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MR. Jeff Black, MA, LPC is a professional counselor in Southlake, TX. MR. Jeff Black, MA, LPC NPI is 1548713217. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

578 N KIMBALL AVE
SUITE 130
SOUTHLAKE, TX
ZIP 76092-883
Phone: (817) 601-5877

The enumeration date for this NPI number is 7/29/2016 and was last updated on 7/29/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	69061	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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