Active NPI
Cynara Black
- Social Worker
- Hill Air Force Base, UT
National Provider Identifier
1003332594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 14185146-3503
- Practice address
- 4006A Hamilton Dr
Hill Air Force Base, UT 84056 - Phone
- (909) 273-8430
- NPI assigned
- Aug 16, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 14185146-3503 | UT | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
4006A Hamilton Dr
Hill Air Force Base, UT 84056
Mailing address
4006A Hamilton Dr
Hill Air Force Base, UT 84056
Phone (909) 273-8430
Other practice location 1
9916 central ave.
montclair, CA 91763
Phone (909) 450-2502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14185146-3503 | UT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734307200000",
"number": "1003332594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4006A HAMILTON DR",
"city": "HILL AIR FORCE BASE",
"state": "UT",
"postal_code": "84056",
"telephone_number": "909-273-8430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4006A HAMILTON DR",
"city": "HILL AIR FORCE BASE",
"state": "UT",
"postal_code": "84056",
"telephone_number": "909-273-8430"
}
],
"practiceLocations": [
{
"address_1": "9916 central ave.",
"address_purpose": "LOCATION",
"city": "montclair",
"state": "CA",
"postal_code": "91763",
"country_code": "US",
"telephone_number": "909-450-2502",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BLACK",
"first_name": "CYNARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-16",
"last_updated": "2024-12-16",
"certification_date": "2024-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "14185146-3503",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hill Air Force Base, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.