DR. JUDITH ANN BLACK PHD, LPC, LCMHC, NCC
NPI 1003110198
Counselor - Professional in Fairmont, WV

Q: What is Judith Black's NPI number?

The NPI number for Judith Black is 1003110198. It was assigned to this individual provider in the NPPES registry on January 4, 2011. The provider is also known as Dr. Jude A. Black Phd.

Q: What is Judith Black's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Judith Black was last updated on March 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 04, 2011PECOS Enrolled

207 FAIRMONT AVE, FAIRMONT, WV 26554(681) 404-6869 Get Directions Write a Review

NPPES record last updated: March 16, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 16, 2023, Apr 14, 2021, Feb 23, 2019 (3 updates tracked since 2019).

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About Dr. Judith Ann Black Phd, Lpc, Lcmhc, Ncc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JUDITH ANN BLACK PHD, LPC, LCMHC, NCC (NPI 1003110198) is an individual professional provider in Fairmont, West Virginia, licensed in West Virginia (2278) and active in the NPI registry since January 2011. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1003110198

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameDR. JUDITH ANN BLACKCredential: PHD, LPC, LCMHC, NCC

Location Address207 FAIRMONT AVEFairmont, WV 26554-2710

Mailing Address12 Woodcliff DrFairmont, WV 26554-1257 · (910) 689-7100

Phone(681) 404-6869

Sole ProprietorYes

Enumeration DateJanuary 4, 2011

Last NPPES UpdateMarch 16, 20233 updates tracked since enumeration

NPPES CertifiedMarch 16, 2023

✔ NPI 1003110198 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

Licenses✔ Licensed in WV · 2278✔ Licensed in NC · A8388✔ Licensed in VA · 0701005401✔ Licensed in NC · 275728✔ Licensed in NC · 8388

207 FAIRMONT AVE, Fairmont, WV 26554

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Other Names 1

Professional Name (2)Dr. Jude A. Black Phd

Secondary Practice Locations 2

Location 112 Woodcliff DrFairmont, WV 26554-1257 · Phone (910) 689-7100

Location 23135 16th Street RdHuntington, WV 25701-5247 · Phone (681) 404-6869 · Fax (681) 404-6871

Other Identifiers 1

MedicaidWVTPID009357WV

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Judith Ann Black Phd, Lpc, Lcmhc, Ncc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANNA CRONIN PLPC

Counselor (Professional)