Individual provider Active NPI

Christine Black

  • Professional Counselor
  • Paducah, KY
National Provider Identifier
1184026528
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC0000003207 Issued in TN
Practice address
425 Broadway St
Paducah, KY 42001-0713
Phone
(270) 442-7121
NPI assigned
Sep 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC0000003207 TN Primary

Addresses

Primary practice location

425 Broadway St
Paducah, KY 42001-0713

Mailing address

408 Virginia St
Paris, TN 38242-5341
Phone (731) 642-0521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20240124002480 KY Practitioner - Mental Health Counselor 6002269248 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC0000003207TNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Western Ky Regional MHMR Board Inc CurrentSince Jan 1, 2024 Accepting new patients
Carey Counseling Center, Inc. PastSince Jul 1, 2015 Accepting new patients

Locations

1525 Cuba Rd
Mayfield, KY 42066
Phone (270) 247-2588

425 Broadway St
Paducah, KY 42001
Phone (270) 442-1452

425 Broadway St
#201
Paducah, KY 42001
Phone (270) 442-1452

425 Broadway St
Ste 102
Paducah, KY 42001
Phone (270) 442-1452

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/careycounselingcenter/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1184026528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 VIRGINIA ST",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382425341",
            "telephone_number": "731-642-0521",
            "fax_number": "731-642-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420010713",
            "telephone_number": "270-442-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "LPC0000003207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.