Veronica Michelle Black, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

080159 Issued in OH

Practice address

14572 US Rte 23
Waverly, OH 45690

Phone

(740) 947-7581

NPI assigned

Aug 23, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Locations

Interoperability endpoints

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

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.

• Pike County Recovery Council Inc

  • Public Health or Welfare Agency
  • Waverly, OH
  • NPI 1275589178
  NPD Authorized official
• Pike County Recovery Council Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waverly, OH
  • NPI 1760742993
  NPD Authorized official

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503446400000",
    "number": "1326565144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 226",
            "address_2": "218 N. EAST ST",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "45690",
            "telephone_number": "740-947-6727",
            "fax_number": "740-835-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14572 US RTE 23",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "45690",
            "telephone_number": "740-947-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "VERONICA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "080159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080159",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jack David Bennett, M.D.
• Elizabeth A Bentley, DO
• Donna Bevens
• Bevins & Schork Chiropractic Clinic LTD
• John Bevins, D.C.
• Kara Blackburn
• Yvonne Leslie Blackburn, CMS
• Toni Rochelle Blair, LPN
• Pauline Blanford, RN,BSN
• Jennifer Lee Blankenship

• All providers in Waverly, OH
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2017; 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.