Thomas C Black, APRN, MSN

Primary specialty

Child & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0807X

License

003424 Issued in CT

Practice address

800 Howard Ave
Yale Physicians BLDG
New Haven, CT 06519-1369

Phone

(203) 785-2140

Fax

(203) 785-6414

NPI assigned

Apr 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1417078122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9805",
            "address_2": "300 GEORGE ST 6TH FLR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065360805",
            "telephone_number": "203-785-7998",
            "fax_number": "203-785-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HOWARD AVE",
            "address_2": "YALE PHYSICIANS BLDG",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191369",
            "telephone_number": "203-785-2140",
            "fax_number": "203-785-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "THOMAS",
        "middle_name": "C",
        "credential": "APRN, MSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "003424",
            "primary": false
        },
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CT",
            "license": "003424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Ann Bivona, PHD
• Samantha Bixby
• Matthew John Bizzarro, MD
• ABA Black, MD, MHS
• Robert Black, MD
• Holly Blackburn
• Leslie Ann Blackburn, D.D.S.
• Katherine Anne Blackwell
• Tecshana Nicola Blackwood, PA
• Caitlin Blair

• Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist in New Haven, CT
• Providers in New Haven, CT by specialty
• Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.