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MS. SIONAG M BLACK PHD
NPI 1821049412
Psychologist - Clinical in Beaver Dam, WI

Active since May 16, 2006
200 FRONT STREET, SUITE 3D, BEAVER DAM, WI 53916(920) 885-2780(920) 885-2788 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Sionag M Black Phd NPPES

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

MS. SIONAG M BLACK PHD (NPI 1821049412) is an individual clinical provider in Beaver Dam, Wisconsin, licensed in Wisconsin (1012057) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1821049412
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameMS. SIONAG M BLACKCredential: PHD
Location Address200 FRONT STREET, SUITE 3DBeaver Dam, WI 53916
Mailing Address200 Front Street, Suite 3dBeaver Dam, WI 53916 · (920) 885-2780 · Fax (920) 885-2788
Phone(920) 885-2780
Fax(920) 885-2788
Sole ProprietorNo
Enumeration DateMay 16, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1821049412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in WI · 1012057
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
200 FRONT STREET, Beaver Dam, WI 53916
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Other Identifiers 2

Medicare ID-Type Unspecified88805
Medicaid39077100WI

Other Providers at the Same Location NPPES 2

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

DR. EUGENE P PHILIPP JR. PSYD
Psychologist (Clinical)
200 FRONT STREET, SUITE 3D
BEAVER DAM, WI 53916
Dodge County (920) 885-2780
DR. KENNETH C GRAUPNER MD
Psychiatry & Neurology (Psychiatry)
200 FRONT STREET, STE 3D
BEAVER DAM, WI 53916
Dodge County (920) 885-2780

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 Sionag Black's NPI number?

The NPI number for Sionag Black is 1821049412. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Where is Sionag Black located?

Sionag Black practices at 200 Front Street Suite 3D, Beaver Dam, WI 53916. The listed phone number is (920) 885-2780.

What is Sionag Black's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Sionag Black was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.