Black, James Henry

Black, James Henry is an individual health care provider with primary practice located at 310 N Midvale Blvd Suite 202, Madison WI 53705-3265. He recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as his primary health care specialty. Black, James Henry can be contacted via phone (609) 852-8600.

Contact Information

Primary practice address
310 N Midvale Blvd Suite 202 Madison WI 53705-3265
Phone: (609) 852-8600
Fax: (608) 238-1929
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X 1620-057 Wisconsin

Profile Details

NPI number 1114088341
LBN Legal business name Black, James Henry
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Aug 22nd, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114088341 NPPES
Wisconsin MEDICAID 39255300

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