MR. SANDRA L BLACK MA, LPC
NPI 1619992054
Counselor - Professional in Fort Worth, TX
- Individual
- Female
- Counselor
- Professional
About SANDRA BLACK
This page provides the complete NPI Profile along with additional information for Sandra Black, a provider established in Fort Worth, Texas with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1619992054 assigned on July 2006. The practitioner's primary taxonomy code is 101YP2500X with license number LPC13288 (TX). The provider is registered as an individual and her NPI record was last updated 11 years ago.
- NPI
- 1619992054 Verify this NPI
- Provider Name
- MR. SANDRA L BLACK MA, LPC
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4200 SOUTH HULEN STREET SUITE 658 FORT WORTH, TX 76109
- Location Phone
- (817) 673-3999
- Location Fax
- (817) 570-0370
- Mailing Address
- 4200 SOUTH HULEN STREET SUITE 658 FORT WORTH, TX 76109
- Mailing Phone
- (817) 673-3999
- Mailing Fax
- (817) 570-0370
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 07-13-2006
- Last Update Date
- 10-27-2015
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
- License No.
- LPC13288
- License State
- TX
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | 13288 (TX) |
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619992054, enumerated as an "individual" on July 13, 2006.
The provider is located at 4200 SOUTH HULEN STREET SUITE 658 FORT WORTH, TX 76109 and the phone number is (817) 673-3999.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
