Black, Judith Lynn

Black, Judith Lynn is an individual health care provider with primary practice located at 6330 Newtown Rd Ste 300 , Norfolk VA 23502-4805. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Black, Judith Lynn can be contacted via phone (757) 466-3336.

Contact Information

Primary practice address
6330 Newtown Rd Ste 300 Norfolk VA 23502-4805
Phone: (757) 466-3336
Fax: (757) 455-5750
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810002873 Virginia
Behavioral Health & Social Service Providers / Clinical 103TC0700X 3019 North Carolina

Profile Details

NPI number 1235170796
LBN Legal business name Black, Judith Lynn
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Feb 2nd, 2023 - about 2 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 1235170796 NPPES
North Carolina MEDICAID 6000829
North Carolina Other 2117520
North Carolina Other 046WJ

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