Elizabeth Anne Renee Black, LLPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401013136 Issued in MI

Practice address

1000 Hastings St
Traverse City, MI 49686-3445

Phone

(231) 947-8110

Fax

(231) 947-3522

NPI assigned

Apr 24, 2019

Last updated

Apr 24, 2019By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Mental Health Counselor

Education

Western Michigan Un Homer Stryker School of Med, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Catholic Human Services, IncGroup PAC ID 4880586494, 14 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.

• Catholic Human Services, Inc

  • Mental Health Counselor
  • Traverse City, MI
  • NPI 1497716047
  Medicare reassignment Care Compare group NPD
• Catholic Human Services Inc.

  • Community/Behavioral Health Agency
  • Gaylord, MI
  • NPI 1508060682
  NPD
• Catholic Charities of Michigan Incorporated

  • Community/Behavioral Health Agency
  • Adrian, MI
  • NPI 1528117744
  NPD (past)

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1841854973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HASTINGS ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863445",
            "telephone_number": "231-947-8110",
            "fax_number": "231-947-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HASTINGS ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863445",
            "telephone_number": "231-947-8110",
            "fax_number": "231-947-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE RENEE",
        "credential": "LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401013136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Birchwood Nursing Center Inc. (Tendercare Health Center - Birchwood)
• Birchwood Nursing Center Inc. (Tendercare Health Center - Birchwood)
• Diana Elizabeth Bischer, NP
• Stephanie Nicole Bishop
• Sonya Biskupski, MS, CCC-SLP
• Jasmine Black
• Shawn Michael Black, M.S., P.T.
• Roxanne Ranae Blackford
• Brittany Kaye Blackmer
• Bobbi Blakeslee, RN

• Mental Health Counselor in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.