Samantha Black, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

08687 Issued in OH

Practice address

2238 S Hamilton Rd Ste 200
Columbus, OH 43232-4382

Phone

(740) 751-0042

NPI assigned

Jul 8, 2021

Last updated

Sep 9, 2024By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Clinical Psychologist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid-Ohio Psychological Services, IncGroup PAC ID 3577585819, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mid-Ohio Psychological Services Inc

  • Counselor
  • Lancaster, OH
  • NPI 1699749457
  Medicare reassignment Care Compare group NPD
• Mid-Ohio Psychological Services Inc

  • Counselor
  • Lancaster, OH
  • NPI 1013274273
  NPD

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1811568025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 STARRET ST STE 100",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303993",
            "telephone_number": "740-687-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2238 S HAMILTON RD STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432324382",
            "telephone_number": "740-751-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "08687",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lora L. Black, PHD
• Margaret Black
• Maureen D Black
• Nicole M Black
• Paige D Black
• Sandra Black, 376J00000X
• Sharon Sue Black, NP-C
• Sylvester Michael Black, MD
• Taiesha Raquel Black
• Tracee Black

• Psychologist in Columbus, OH
• Providers in Columbus, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.