Wendie G Black, MA

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

3041974 Issued in AZ

Practice address

3490 E. Rio Virgin Rd.
Littlefield, AZ 86432

Phone

(928) 347-5486

Fax

(928) 347-5967

NPI assigned

Nov 19, 2011

Last updated

Nov 19, 2011By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1321660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321660800000",
    "number": "1386911386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 E. RIO VIRGIN RD.",
            "city": "LITTLEFIELD",
            "state": "AZ",
            "postal_code": "86432",
            "telephone_number": "928-347-5486",
            "fax_number": "928-347-5967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 E. RIO VIRGIN RD.",
            "city": "LITTLEFIELD",
            "state": "AZ",
            "postal_code": "86432",
            "telephone_number": "928-347-5486",
            "fax_number": "928-347-5967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "WENDIE",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-19",
        "last_updated": "2011-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "AZ",
            "license": "3041974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen M Adam, DMD
• Beaver Dam Littlefield Fire District
• James Alton Callis Jr., PA-C
• Alejandra Camacho, RDH
• Canyonlands Community Health Care (Canyonlands Health Care - Beaver Dam)
• Lacey Bennett Celani, NP
• Community Bridges, Inc. (CBI - Encompass Littlefield Outpatient)

• School Psychologist in Littlefield, AZ
• Providers in Littlefield, AZ by specialty
• School Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; 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.