Glenetta R Black, MS, PMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

9886 Issued in NE

Practice address

3040 Lake St Ste 118
Omaha, NE 68111-3700

Phone

(402) 215-3433

Fax

(402) 445-4498

NPI assigned

Feb 8, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1360281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360281600000",
    "number": "1649519737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 LAKE ST STE 118",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681113700",
            "telephone_number": "402-215-3433",
            "fax_number": "402-445-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 LAKE ST STE 118",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681113700",
            "telephone_number": "402-215-3433",
            "fax_number": "402-445-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "GLENETTA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "MS, PMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-08",
        "last_updated": "2013-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "9886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretchen Bjerke
• Tara Elizabeth Bjorklund, DO
• Deborah Bjorman, ARNP
• Cherelle Black
• Emma Black
• Jennifer Lynn Black
• Julia L Black, DO
• Karlee Black, DO
• Katherine Evans Black, DNP, APRN, CPNP
• Kenneth Steven Black

• Mental Health Counselor in Omaha, NE
• Providers in Omaha, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; 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.