NPIMap

Organization Active NPI

Kenyatta Black Counseling LLC

  • Professional Counselor
  • Arlington, TX
National Provider Identifier
1275010308
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
KENYATTA BLACK COUNSELING LLC
Practice address
3939 W Green Oaks Blvd Ste 214
Arlington, TX 76016-2793
Phone
(469) 490-1442
NPI assigned
Jul 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

Name
Kenyatta Black
Title
Owner
Phone
(469) 490-1442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

3939 W Green Oaks Blvd Ste 214
Arlington, TX 76016-2793

Mailing address

607 Sotogrande St
Grand Prairie, TX 75051-4456
Phone (214) 298-2780

Other identifiers 1

IdentifierTypeStateIssuer
284297301MedicaidTX

National Provider Directory

National Provider Directory

Locations

3939 W Green Oaks Blvd
Ste 214
Arlington, TX 76016
Phone (469) 490-1142

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1275010308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 SOTOGRANDE ST",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750514456",
            "telephone_number": "214-298-2780",
            "fax_number": "214-380-4965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 W GREEN OAKS BLVD STE 214",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760162793",
            "telephone_number": "469-490-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENYATTA BLACK COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-21",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "KENYATTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-490-1442"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "284297301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.