Elizabeth Black

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34011206A Issued in IN

Practice address

107 Woodland CT Ste B
Michigan City, IN 46360-7393

Phone

(219) 229-7188

NPI assigned

Jul 25, 2023

Last updated

Sep 24, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

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.

• Porter-Starke Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valparaiso, IN
  • NPI 1689627598
  Medicare reassignment NPD
• Lotus Life Counseling PC

  • Clinical Social Worker
  • Michigan City, IN
  • NPI 1912878893
  NPD Authorized official
• Porter-Starke Services Inc.

  • Federally Qualified Health Center (FQHC)
  • Valparaiso, IN
  • NPI 1659196236
  NPD
• Porter-Starke Services Inc.

  dba Marram Health Center

  • Federally Qualified Health Center (FQHC)
  • Gary, IN
  • NPI 1023485356
  NPD (past)
• Porter-Starke Services Inc.

  dba Marram Health Center Portage

  • Federally Qualified Health Center (FQHC)
  • Portage, IN
  • NPI 1588301899
  NPD (past)
• Porter-Starke Services, Inc.

  dba Marram Health Center

  • Federally Qualified Health Center (FQHC)
  • Hebron, IN
  • NPI 1447815758
  NPD (past)

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1063193902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 KINGSBURY AVE",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463505260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WOODLAND CT STE B",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607393",
            "telephone_number": "219-229-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-25",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33010846A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34011206A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bikash Agarwal, Inc
• Bikashagarwal Inc.
• Bionic Prosthetics and Orthotics Group LLC
• BKRD, Inc
• Billie-Ann Black, DNP
• Karmyn Boller, LSW
• Chad A Booth, LSW
• Marc Alan Booth, MD
• Thomas J Bormann, DDS
• Jacob Bowersock

• Clinical Social Worker in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.