Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JOHN W BLACK JR. MS, LPA
NPI 1457401945
Counselor - Professional in Georgetown, KY

Q: What is John Black's NPI number?

The NPI number for John Black is 1457401945. It was assigned to this individual provider in the NPPES registry on January 10, 2007.

Q: What is John 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 John Black was last updated on July 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 32 days 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 10, 2007PECOS Enrolled

110 ROACH ST, GEORGETOWN, KY 40324(859) 253-1686(859) 254-2743 Get Directions Write a Review

NPPES record last updated: July 22, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About John W Black Jr. Ms, Lpa NPPES

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

JOHN W BLACK JR. MS, LPA (NPI 1457401945) is an individual professional provider in Georgetown, Kentucky, licensed in Kentucky (241827) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of Other (1992).

NPPES Registry Identity

NPI1457401945

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameJOHN W BLACK JR.Credential: MS, LPA

Location Address110 ROACH STGeorgetown, KY 40324-9393

Mailing Address1351 Newtown PikeLexington, KY 40511-1217 · (859) 253-1686 · Fax (859) 254-2743

Phone(859) 253-1686

Fax(859) 254-2743

Sole ProprietorNo

Medical School CMSOtherGraduated 1992

Enumeration DateJanuary 10, 2007

Last NPPES UpdateJuly 22, 2026

NPPES CertifiedJuly 22, 2026

✔ NPI 1457401945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in KY · 241827

110 ROACH ST, Georgetown, KY 40324

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Other Identifiers 1

Medicaid30615058KY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John W Black Jr. Ms, Lpa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7113494485

PECOS Enrollment IDI20260423001871

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 18

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

MS. ANNE G KEENAN CSW

Social Worker