JOHNATHAN SHANE BLACK (NPI# 1316459084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316459084 |
| Entity Type | Individual |
| Full Name | JOHNATHAN SHANE BLACK |
| Practice Address |
7120 Airport Blvd Mobile AL 36608-4502 |
| Practice Telephone | 2513453303 |
| Mailing Telephone | 2513453303 |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2017-11-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
3106 | AL | Behavioral Health & Social Service Providers |
| Street Address |
7120 AIRPORT BLVD |
| City | MOBILE |
| State | AL |
| Zip Code | 36608-4502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124531041 | Zach Thompson Lpc | Clinic/Center | 7120 Airport Blvd, Mobile, AL 36608-4502 | 2017-11-14 |
| 1588177570 | Grace Counseling Center | Clinic/Center | 7120 Airport Blvd, Mobile, AL 36608 | 2017-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475524 | Grantham Dental, Inc. | Dentist | 3620 Springhill Memorial Drive South, Mobile, AL 36608 | 2020-10-21 |
| 1114540879 | Dearrius Hines | Home Health Aide | 1370 Lucerne Dr, Mobile, AL 36608 | 2020-05-28 |
| 1558980409 | Rachel Stevens | Registered Nurse | 8507 Tanner Williams Rd, Mobile, AL 36608 | 2020-04-10 |
| 1073170700 | Usa Health Physician Billing Services LLC | Otolaryngology | 5721 Usa Drive North, Hahn 1119, Mobile, AL 36608 | 2019-05-29 |
| 1952885600 | Franklin Primary Health Center Inc. | Dentist | 990 Cody Rd North, Mobile, AL 36608 | 2018-09-19 |
| 1114410040 | Zackary Elkins | Optometrist | 105 W I65 Service Rd N, Mobile, AL 36608 | 2018-06-14 |
| 1023562865 | Covenant Hospice, Inc. | Internal Medicine | 6801 Airport Blvd., Main Tower, 11th Floor North, Mobile, AL 36608 | 2016-08-10 |
| 1730575416 | Rayven Likely | Student in an Organized Health Care Education/Training Program | 1014 Centerwood Dr, Mobile, AL 36608 | 2015-04-09 |
| 1598040461 | Robert S Harlin | Specialist | 75 Clarise Circle, Mobile, AL 36608 | 2011-10-11 |
| 1972884948 | Heidi Michelle Mcdermott | Physical Therapist | 5721 Usa Drive N, Hahn 2050, Mobile, AL 36608 | 2011-09-06 |
| Find all providers in zip 36608 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677596 | Linda Jean Hayes | Counselor | 2146 Carson Court, Mobile, AL 36695 | 2020-10-22 |
| 1811506207 | Susan Marisa Boucher | Counselor | 3925 Spring Hill Ave, Mobile, AL 36608-5730 | 2020-07-30 |
| 1275151433 | John Amado Llauget | Counselor | 326 Spring Lake Dr N, Mobile, AL 36695-3434 | 2020-07-13 |
| 1295368256 | Tammera Carbo | Counselor | 150 Du Rhu Dr Apt 102, Mobile, AL 36608-1221 | 2020-02-19 |
| 1851931927 | The Space: A Counseling Center, LLC | Counselor | 600 Bel Air Blvd Ste 133, Mobile, AL 36606-3501 | 2020-01-07 |
| 1164064978 | Crystal Aerin Deweever | Counselor | 2400 Gordon Smith Dr., Mobile, AL 36617 | 2019-10-14 |
| 1689216376 | Courtney Taylor Nall-mcculley | Counselor | 3929 Airport Blvd Ste 2-413, Mobile, AL 36609-2239 | 2019-10-14 |
| 1831746601 | Ecm Counseling, LLC | Counselor | 316 Bel Air Blvd., Suite 304, Mobile, AL 36606-3507 | 2019-08-26 |
| 1396211280 | Shalonda Jeanine Sewell | Counselor | 273 Cedar Dr, Mobile, AL 36617-3951 | 2018-10-17 |
| 1295236008 | Sara E Kenny | Counselor | 248 Cox St Ste B, Mobile, AL 36604-3303 | 2018-02-27 |
| Find all providers in MOBILE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.