Emily Black

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

250 Watertower Byp
Campbellsville, KY 42718-7654

Phone

(270) 465-7424

Fax

(270) 465-7993

NPI assigned

Mar 29, 2021

Sex

Female

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

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bluegrass Professional Counseling, LLC

  • Professional Counselor
  • Munfordville, KY
  • NPI 1063899789

  KY

  Medicare reassignment NPD
• Kimberly Gambino LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Munfordville, KY
  • NPI 1417511973
  NPD (past)

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1629655188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SOUTHERN SCHOOL RD",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425013223",
            "telephone_number": "606-679-4782",
            "fax_number": "606-678-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 WATERTOWER BYP",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427187654",
            "telephone_number": "270-465-7424",
            "fax_number": "270-465-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Eric Bentley, M.D.
• Deborah Bentley, ARNP
• Better Hearing Center
• Bradley Alvin Bickett, OT
• Bio-Medical Applications of Kentucky, Inc.
• McKenzie Lynn Blacketer, MSN, APRN, FNP
• Faron Blakeman
• Danny Blanton Jr., TCM
• Heather June Blanton, MMFT, CFLE
• Bloom Supports

• All providers in Campbellsville, KY
• Mental Health Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.