Judith Ann Black, PHD, LPC, LCMHC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2278 Issued in WV

Practice address

207 Fairmont Ave
Fairmont, WV 26554-2710

Phone

(681) 404-6869

NPI assigned

Jan 4, 2011

Last updated

Mar 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Dr. Jude A. Black Professional name

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Appalachian Counseling Center LLCGroup PAC ID 5597115782, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Appalachian Counseling Center LLC

  dba Appalachian Life Enrichment Counseling Center

  • Psychologist
  • Fairmont, WV
  • NPI 1568928877

  Professional

  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1003110198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WOODCLIFF DR",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541257",
            "telephone_number": "910-689-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 FAIRMONT AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542710",
            "telephone_number": "681-404-6869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Woodcliff Dr",
            "address_purpose": "LOCATION",
            "city": "Fairmont",
            "state": "WV",
            "postal_code": "265541257",
            "country_code": "US",
            "telephone_number": "910-689-7100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3135 16th Street Rd",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257015247",
            "country_code": "US",
            "telephone_number": "681-404-6869",
            "fax_number": "681-404-6871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "JUDITH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, LCMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-04",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A8388",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701005401",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "275728",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "8388",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "2278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WVTPID009357",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hello@wvcounseling.com",
            "affiliation": "N",
            "endpointDescription": "Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "207 Fairmont Ave",
            "city": "Fairmont",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265542710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drjude@wvcounseling.com",
            "affiliation": "Y",
            "endpointDescription": "Clinic",
            "affiliationName": "Appalachian Life Enrichment Counseling Center LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "207 Fairmont Ave",
            "city": "Fairmont",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265542710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hello@wvcounseling.com",
            "affiliation": "N",
            "endpointDescription": "Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "207 Fairmont Ave",
            "city": "Fairmont",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265542710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JUDE",
            "last_name": "BLACK",
            "middle_name": "A.",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sonya Bingamon
• Bio-Medical Applications of West Virginia, Inc. (FMC Dialysis Services of Fairmont)
• Bioscrip Infusion Services, LLC (BioScrip Infusion Services)
• Bioscrip Infusion Services, LLC (BioScrip Infusion Services)
• Nicole Marie Bissett
• Jennifer Blackwood
• Rhonda C Bland
• Mary I Blaniar
• Christopher Allen Blankenship
• Breahna Bleigh

• Professional Counselor in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Professional Counselor in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.