Kimberly Danielle Black

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

2801 Buford Hwy NE Ste 501
Brookhaven, GA 30329-2137

Phone

(770) 696-6311

NPI assigned

Oct 31, 2022

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1851008932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6218 RIDDLE CT",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301343719",
            "telephone_number": "404-484-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 BUFORD HWY NE STE 501",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292137",
            "telephone_number": "770-696-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KIMBERLY",
        "middle_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bakari Bethea, RBT
• Tasneem H Bhatia, MD
• Mia Bishop
• Amy Elizabeth Bixler
• Jessica Black, RPH
• Elizabeth Blair, M.ED. CCC-SLP
• Miranda Fordham Blais, WHNP-BC
• Michelle Blalock, PHARMD
• Bliss Healthcare Solutions LLC
• Kristie Erin Bobek, FNP-C

• All providers in Brookhaven, GA
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.