Travis Black

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

735 S 200 W Ste 1
Blanding, UT 84511-3923

Phone

(435) 678-2992

Fax

(435) 678-3116

NPI assigned

Aug 16, 2019

Last updated

Aug 16, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• San Juan Mental Health-Substance Abuse Special Service District

  dba San Juan Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Blanding, UT
  • NPI 1356353692
  NPD

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1356997134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 S 200 W STE 1",
            "city": "BLANDING",
            "state": "UT",
            "postal_code": "845113923",
            "telephone_number": "435-678-2992",
            "fax_number": "435-678-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 S 200 W STE 1",
            "city": "BLANDING",
            "state": "UT",
            "postal_code": "845113923",
            "telephone_number": "435-678-2992",
            "fax_number": "435-678-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "TRAVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna K. Bethea
• Janice Bitsoie
• Emma Nicole Melo Black
• Megan Louise Black, PA
• Sterling Black, D.C.
• Morgan Blackhorse
• Generra Blake
• Blue Mountain Hospital
• Blue Mountain Hospital
• Blue Mountain Hospital (Blue Mountain Hospital-Swing Beds)

• Mental Health Counselor in Blanding, UT
• Providers in Blanding, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.