Liz-El Dominique Black

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

124 John Robert Thomas Dr
Exton, PA 19341-2655

Phone

(484) 987-9870

NPI assigned

Nov 3, 2023

Last updated

Nov 3, 2023By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1245003961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 VAN SANT LN",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190025054",
            "telephone_number": "215-421-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 JOHN ROBERT THOMAS DR",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412655",
            "telephone_number": "484-987-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "LIZ-EL",
        "middle_name": "DOMINIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Margaret Bianchini, PA-C
• Candice Lynn Bieganski
• Elin M. Bierly, LICENSED PSYCHOLOGIS
• Deborah Bieter -Schultz, DO
• Alicia Billups, PA-C
• Lincoln William Blackwell, LPC
• Michael James Blahut III, D.O.
• Edward Molette Blanchard, PA-C
• Michael Block, CRNP
• Bloom Life Enterprises

• Counselor in Exton, PA
• Providers in Exton, PA by specialty
• Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.