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KELLY BLACK
NPI 1871471177
Peer Specialist in Chardon, OH

Active since August 25, 2025
12557 RAVENWOOD DR, CHARDON, OH 44024(440) 285-3568 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kelly Black NPPES

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

KELLY BLACK (NPI 1871471177) is an individual peer specialist in Chardon, Ohio and active in the NPI registry since August 2025.

NPPES Registry Identity

NPI1871471177
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameKELLY BLACK
Location Address12557 RAVENWOOD DRChardon, OH 44024-9009
Mailing Address12557 Ravenwood DrChardon, OH 44024-9009 · (440) 285-3568
Phone(440) 285-3568
Sole ProprietorNo
Enumeration DateAugust 25, 2025
NPPES CertifiedAugust 25, 2025
✔ NPI 1871471177 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
12557 RAVENWOOD DR, Chardon, OH 44024
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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.

KAILYN JOAN RATLIFF LPN
Licensed Practical Nurse
12557 RAVENWOOD DR
CHARDON, OH 44024
Geauga County (440) 285-3568
BILLIE SATAVA
Case Manager/Care Coordinator
12557 RAVENWOOD DR
CHARDON, OH 44024
Geauga County (440) 285-2170
AUDREE ALICK LSW
Social Worker
12557 RAVENWOOD DR
CHARDON, OH 44024
Geauga County (440) 285-3568
WENDY MERLENE FRANCIS LPC
Counselor
12557 RAVENWOOD DR
CHARDON, OH 44024
Geauga County (440) 285-3568
TRISHA LYNN SIMONYI
Case Manager/Care Coordinator
12557 RAVENWOOD DR
CHARDON, OH 44024
Geauga County (440) 285-3568
VANESSA PLAUTZ
Peer Specialist
12557 RAVENWOOD DR
CHARDON, OH 44024
Geauga County (440) 285-3568
JOSHUA MARK RUBIN
Case Manager/Care Coordinator
12557 RAVENWOOD DR
CHARDON, OH 44024
Geauga County (440) 285-3568
CAROLYN GARDNER
Licensed Practical Nurse
12557 RAVENWOOD DR
CHARDON, OH 44024
Geauga County (440) 285-3568

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 Kelly Black's NPI number?

The NPI number for Kelly Black is 1871471177. It was assigned to this individual provider in the NPPES registry on August 25, 2025.

Where is Kelly Black located?

Kelly Black practices at 12557 Ravenwood Dr, Chardon, OH 44024. The listed phone number is (440) 285-3568.

What is Kelly Black's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Kelly Black was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.