DR. MICHAEL RICHARD BLACK PSYD
NPI 1699061390
Psychologist in Chicago, IL

Active since June 22, 2011PECOS EnrolledAccepts Medicare Assignment
3139 N LINCOLN AVE STE 221, CHICAGO, IL 60657(773) 458-0585(999) 999-9999 Get Directions Write a Review

NPPES record last updated: May 13, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 13, 2022, Apr 30, 2022 (2 updates tracked since 2022).

About Dr. Michael Richard Black Psyd NPPES

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

DR. MICHAEL RICHARD BLACK PSYD (NPI 1699061390) is an individual psychologist in Chicago, Illinois, licensed in Illinois (071008134) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1699061390
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. MICHAEL RICHARD BLACKCredential: PSYD
Location Address3139 N LINCOLN AVE STE 221Chicago, IL 60657-3122
Mailing Address2230 N Kostner AveChicago, IL 60639-3532 · (773) 278-2643 · Fax (999) 999-9999
Fax(999) 999-9999
Sole ProprietorYes
Medical School CMSOtherGraduated 2007
Enumeration DateJune 22, 2011
Last NPPES UpdateMay 13, 20222 updates tracked since enumeration
NPPES CertifiedMay 13, 2022
NPI 1699061390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in IL · 071008134
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

3139 N LINCOLN AVE STE 221, Chicago, IL 60657

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Michael Richard Black Psyd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406014547
PECOS Enrollment IDI20120221000879
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
322 services15 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Black's NPI number?

The NPI number for Michael Black is 1699061390. It was assigned to this individual provider in the NPPES registry on June 22, 2011.

Where is Michael Black located?

Michael Black practices at 3139 N Lincoln Ave Ste 221, Chicago, IL 60657. The listed phone number is (773) 458-0585.

What is Michael Black's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Michael Black enrolled in Medicare?

Yes. Michael Black is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Michael Black was last updated on May 13, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.