Marcia Gail Black, PHD
Individual provider Active NPI Psychologist · Amherst, MA
NPI 1114018488 · NPPES record last updated May 10, 2023
Key facts
- NPI
- 1114018488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- MA6786PSYCH (MA)
- Practice address
- 9 Research Dr
Amherst, MA 01002-2774 - Phone
- (413) 687-7559
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
441 W St
Suite 1a
Amherst, MA 01002
Phone (413) 687-7559
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040917000640 | MA | Practitioner - Clinical Psychologist | 1456329440 | Practice locations: Amherst, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA6786PSYCH | MA | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | MA6786PSYCH | MA | Yes |
Addresses
Primary practice location
9 Research Dr
Amherst, MA 01002-2774
Mailing address
9 Research Dr Ste 1a
Amherst, MA 01002-2775
Phone (413) 687-7559
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000533266 | Other | AETNA | |
| 8635 | Other | UBH | |
| 028140 | Other | MA | BOSTON MED CENTER HEALTH |
| 1853601 | Medicaid | MA | |
| 357374 | Other | TUFTS |
Other providers in Amherst, MA
- R. Stuart Bicknell
- Joanna Bielin
- Martha Bishop
- Melanie Bitely
- Gary F Bivona
- Emily Bloch
- Lynette Bloise
- Peter Mitchell Blood
- Frederick H Bloom
- Karen Susan Blum
All providers in Amherst, MA · Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.