Sharon Black, PHD, LP

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Practice address

1774 Sheridan Ave
Saint Paul, MN 55116-2730

Phone

(763) 222-7362

NPI assigned

Aug 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1851845267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 SHERIDAN AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162730",
            "telephone_number": "763-222-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1774 SHERIDAN AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162730",
            "telephone_number": "763-222-7362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Aylesworth Hl NW Dept 8010",
            "address_2": "Colorado State University",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805238010",
            "country_code": "US",
            "telephone_number": "970-491-6053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "SHARON",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BK Nemt LLC
• Carrie Ann Black Bourassa, RRT
• Black Legacy Group LLC
• James E Black, M.D.
• Meghan T Black, DDS
• Monty Blackberg
• Brian E. Blackwell, DDS
• Rebecca Lynn Blackwell
• Alisa Blackwood, CD(DONA)
• Garrett Franklin Blaha, RN

• Counseling Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.