Individual provider Active NPI

Barbara Black, LPC

  • Professional Counselor
  • Saint Louis, MO
National Provider Identifier
1689176802
Registry record updated Mar 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2012026716 Issued in MO
Practice address
774 Glenway Dr
Saint Louis, MO 63122-3243
Phone
(314) 690-3212
NPI assigned
Mar 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2012026716 MO Primary

Addresses

Primary practice location

774 Glenway Dr
Saint Louis, MO 63122-3243

Mailing address

774 Glenway Dr
Saint Louis, MO 63122-3243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 30, 2025 through Jun 30, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2012026716MOMDProfessional Counselor
4432CTMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1520035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520035200000",
    "number": "1689176802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 GLENWAY DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 GLENWAY DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223243",
            "telephone_number": "314-690-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "BARBARA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-03",
        "last_updated": "2018-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2012026716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.