Black, David L.
Black, David L. is an individual health care provider with primary practice located at 1531 E Bradford Pkwy Ste 210-4, Springfield MO 65804-6566. He recently has 8 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Health Service, Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Group Psychotherapy, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Health Service is his primary health care specialty. Black, David L. can be contacted via phone (417) 890-4083.Contact Information
Primary practice address
1531 E Bradford Pkwy Ste 210-4
Springfield MO 65804-6566
Phone: (417) 890-4083
Fax: (417) 890-4091
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2001004284 | Missouri |
| Behavioral Health & Social Service Providers / Health Service | 103TH0100X | 2009026793 | Missouri |
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 2001004284 | Missouri |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X | 2009026793 | Missouri |
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | 2009026793 | Missouri |
| Behavioral Health & Social Service Providers / Group Psychotherapy | 103TP2701X | 2009026793 | Missouri |
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | 2009026793 | Missouri |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2009026793 | Missouri |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 2009026793 | Missouri |
Profile Details
| NPI number | 1386640159 |
|---|---|
| LBN Legal business name | Black, David L. |
| Credentials | PSY.D., LCSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2005 |
| Last updated | Apr 21st, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386640159 | NPPES |
| Missouri | MEDICAID | 494960107 |
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