Trasha Jacquette Black, PHD, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4047 Issued in NC

Practice address

5104 Reagan Dr Ste 5
Charlotte, NC 28206-1392

Phone

(704) 596-0505

Fax

(704) 596-0507

NPI assigned

Jul 3, 2006

Last updated

Jan 24, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Genesis Project 1

  • Point of Service
  • Charlotte, NC
  • NPI 1417364480
  NPD Authorized official
• Genesis Project Family Wellness Center, Inc.

  • Community Health Clinic/Center
  • Charlotte, NC
  • NPI 1841866068
  Authorized official Same address or phone
• Genesis Project Medical Laboratory

  • Clinical Medical Laboratory
  • Charlotte, NC
  • NPI 1700403425
  NPD (past) Authorized official
• Groundwater Solutions, Inc.

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1013532456
  Authorized official Same address or phone
• Genesis Project 1, Inc

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1326187469
  NPD

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1730119363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560723",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282560723",
            "telephone_number": "704-596-0505",
            "fax_number": "704-596-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5104 REAGAN DR STE 5",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282061392",
            "telephone_number": "704-596-0505",
            "fax_number": "704-596-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "TRASHA",
        "middle_name": "JACQUETTE",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "4047",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "4047",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "4047",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "142A2",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102098",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Para Evette Black, BSW
• Parker Black
• Reneisha Lachelle Black, LPCA
• Shaphaun Tamara Black, CSAC
• Sheila Ruth Black, LCSW
• Collin William Blackburn, MD
• Jennifer Jill Blackburn, M. ED., BCBA
• Stephanie Anne Blackburn, LCSW
• Donald Wayne Blackley, M.D.
• Aaron T Blackmer, P.A

• Professional Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.