Active NPI
Johanna Black
- Professional Counselor
- Emporia, KS
National Provider Identifier
1619854981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 05079
- Practice address
- 417 Commercial St Ste 5
Emporia, KS 66801-4080 - Phone
- (620) 412-7770
- NPI assigned
- Aug 19, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05079 | KS | MD | Professional Counselor |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 05079 | KS | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
417 Commercial St Ste 5
Emporia, KS 66801-4080
Mailing address
915 Oxford Dr
Emporia, KS 66801-5438
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 11, 2026.
{
"created_epoch": "1755561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770768000000",
"number": "1619854981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 OXFORD DR",
"city": "EMPORIA",
"state": "KS",
"postal_code": "668015438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 COMMERCIAL ST STE 5",
"city": "EMPORIA",
"state": "KS",
"postal_code": "668014080",
"telephone_number": "620-412-7770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "JOHANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-19",
"last_updated": "2026-02-11",
"certification_date": "2026-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KS",
"license": "05079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Emporia, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.