Micaela T Black, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MHC00421 Issued in RI

Practice address

107 Clock Tower SQ
Suite 107
Portsmouth, RI 02871-1396

Phone

(401) 255-4299

NPI assigned

Jul 11, 2009

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1247270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247270400000",
    "number": "1629207626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 N CHRISTOPHER AVE",
            "city": "TIVERTON",
            "state": "RI",
            "postal_code": "028783885",
            "telephone_number": "401-255-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CLOCK TOWER SQ",
            "address_2": "SUITE 107",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028711396",
            "telephone_number": "401-255-4299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MICAELA",
        "middle_name": "T",
        "name_prefix": "Miss",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-11",
        "last_updated": "2009-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC00421",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "RI",
            "license": "0005601",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanley A Baranosky, RPH
• Howard Israel Benesch, PHD
• Douglas B. Bernon, PH.D., PH.D.
• Maria Besedin, LMHC
• David Bettencourt
• Nancy Black
• Abigail Bloom, RD
• Eleanor Bodell-Kudla, OTR/L
• Aliza Bogdanich, LCDP
• Andrea J Bond, MD

• Mental Health Counselor in Portsmouth, RI
• Providers in Portsmouth, RI by specialty
• Mental Health Counselor in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2009; 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.