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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386640159 NPPES
Missouri MEDICAID 494960107

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