Active NPI
Christopher Black
- Mental Health Counselor
- Jacksonville, FL
National Provider Identifier
1619520467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 4131 University Blvd S
Jacksonville, FL 32216-4326 - Phone
- (904) 745-0067
- NPI assigned
- Jul 22, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
4131 University Blvd S
Jacksonville, FL 32216-4326
Mailing address
2504 Van Gundy Rd
Jacksonville, FL 32208-2583
Phone (904) 446-7427
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563753600000",
"number": "1619520467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2504 VAN GUNDY RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322082583",
"telephone_number": "904-446-7427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4131 UNIVERSITY BLVD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322164326",
"telephone_number": "904-745-0067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "CHRISTOPHER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-22",
"last_updated": "2019-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.