Kristy Terry Black

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ALC04266 Issued in AL

Practice address

198 US Highway 278 E
Cullman, AL 35055-0690

Phone

(888) 355-7080

Fax

(256) 615-8632

NPI assigned

Oct 17, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1730805201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1324",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350561324",
            "telephone_number": "888-355-7080",
            "fax_number": "256-615-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 US HIGHWAY 278 E",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350550690",
            "telephone_number": "888-355-7080",
            "fax_number": "256-615-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KRISTY",
        "middle_name": "TERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "ALC04266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235540",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@ybrcounseling.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "198 US Highway 278 E",
            "city": "Cullman",
            "state": "AL",
            "country_code": "US",
            "postal_code": "350550690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew Edward Bishop
• Karen Denise Bissell, MA
• D'Lisa Ann Bitterly, MD
• Andrea Maurice Black, PHARMD
• Deborah Dianne Black, MA
• Natasha Black, MS
• Stephen Anthony Black, PD
• Warren D Blackburn Jr., M.D.
• Gordon R Blair, CRNP
• Heidi Blair, M.D.

• Mental Health Counselor in Cullman, AL
• Providers in Cullman, AL by specialty
• Mental Health Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.