Lucie A Black, L.P.C.
Individual provider Active NPI Mental Health Counselor · Corsicana, TX
NPI 1255900262 · NPPES record last updated Jun 23, 2021
Key facts
- NPI
- 1255900262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 18950 (TX)
- Practice address
- 715 W 2ND Ave
Corsicana, TX 75110-3012 - Phone
- (903) 872-4442
- Fax
- (903) 872-2125
- NPI assigned
- Jun 23, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Philip R Taft PSYD PLLC
Practice addresses (Care Compare)
715 W 2ND Ave
Corsicana, TX 75110-3012
Phone (903) 872-4443
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- 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 |
|---|---|---|---|---|
| I20240726001282 | TX | Practitioner - Mental Health Counselor | 7214473123 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Philip R. Taft Psy.D. PLLC | Current |
Accepting new patients |
Locations
715 W 2nd Ave
Corsicana, TX 75110
Phone (903) 872-4442
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 18950 | TX | Yes |
Addresses
Primary practice location
715 W 2ND Ave
Corsicana, TX 75110-3012
Mailing address
620 S 9TH Ave
Teague, TX 75860-2208
Phone (254) 625-2780
Other providers in Corsicana, TX
- Bethany HH of Corsicana
- Chloe Elysse Bethea
- John M Biltz
- Oswald S Binford
- Bio-Medical Applications of Texas, Inc.
- David Blackburn
- Ashley Blair
- Michelle Blank
- William Blessing
- Bluebonnet Emergency Physicians
All providers in Corsicana, TX · Mental Health Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2021. 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.