Joseph Edward Black, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

4889 Issued in OH

Practice address

731 E Main St
Suite 13
Jackson, OH 45640-2100

Phone

(740) 286-8789

Fax

(740) 286-8789

NPI assigned

Jan 12, 2007

Last updated

Nov 22, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• J. Edward Black Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1124178918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 CREMEENS RD",
            "city": "PATRIOT",
            "state": "OH",
            "postal_code": "456589319",
            "telephone_number": "740-256-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 E MAIN ST",
            "address_2": "SUITE 13",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456402100",
            "telephone_number": "740-286-8789",
            "fax_number": "740-286-8789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "JOSEPH",
        "middle_name": "EDWARD",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OH",
            "license": "4889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J.",
            "last_name": "BLACK",
            "middle_name": "EDWARD",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jamie L Bennett, CDCA.169712
• Sheridan A Benson
• Richard Harris Billman II, OD
• Bio-Medical Applications of Ohio Inc (Fresenius Medical Care Indian Hills)
• Stephanie Ruth Bixler, NP-C
• Micah Nicole Blankenship
• Natosha D Blanton
• Caitlyn Blevins
• Lori Bock
• Jessica Boggs

• Counseling Psychologist in Jackson, OH
• Providers in Jackson, OH by specialty
• Counseling Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.