Sara Black, LPC, LCDC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

68080 Issued in TX

Practice address

12740 Hillcrest Rd Ste 224
Dallas, TX 75230-2168

Phone

(972) 863-7133

Fax

(844) 318-2942

NPI assigned

Jul 10, 2015

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grace to Grow

  • Substance Use Disorder Rehabilitation Clinic/Center
  • McKinney, TX
  • NPI 1508127846
  NPD (past)

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1831573757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12740 HILLCREST RD STE 224",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302168",
            "telephone_number": "972-863-7133",
            "fax_number": "844-318-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12740 HILLCREST RD STE 224",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302168",
            "telephone_number": "972-863-7133",
            "fax_number": "844-318-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "SARA",
        "name_prefix": "Ms.",
        "credential": "LPC, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-10",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "11507",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "68080",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "68080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Black, PH.D.
• Michael Edward Black, M.D.
• Robert D Black, M.D.
• Ryan Edwards Black, BCBA
• Ryan W. T. Black, PA-C
• Stephen Black, MD
• Stuart Barry Black, MD
• Timothy Scott Black, LMSW
• William Christopher Black, MD
• Blackburn Management

• Counseling Psychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.