Michele Catherine Black, M.A.CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA8723 Issued in FL

Practice address

1757 Indiana Ave
Winter Park, FL 32789-5446

Phone

(407) 461-7787

Fax

(407) 988-1514

NPI assigned

Oct 15, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Funshine Therapy LLC

  • Clinic/Center
  • Mount Dora, FL
  • NPI 1649986647

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739664000000",
    "number": "1164512455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1757 INDIANA AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327895446",
            "telephone_number": "407-461-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 INDIANA AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327895446",
            "telephone_number": "407-461-7787",
            "fax_number": "407-988-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MICHELE",
        "middle_name": "CATHERINE",
        "credential": "M.A.CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-15",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA8723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890920200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Birkmire Behavioral Healthcare
• Rosally N Bisbal Moreno, PSYD
• Karina Isabel Bishop, M.D.
• Katelyn Barbara Bitetto Davis, APRN
• Mary Ann Black, RN
• Victoria Marie Black
• Cassidy Rose Blackton
• Kimberly Blakely, OT
• Gloria Clemencia Blakley, MA-CMHC-CABA
• Dany Blanchet, OTR/L

• Speech-Language Pathologist in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.