BLACK LADIES INTERNATIONAL, INC. (NPI# 1659934255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659934255 |
| Entity Type | Organization |
| Organization Name | BLACK LADIES INTERNATIONAL, INC. |
| Practice Address |
10475 Medlock Bridge Rd Ste 205 Duluth GA 30097-4446 |
| Mailing Address |
3005 Jester Ct Duluth GA 30096-3862 |
| Practice Telephone | 6783793781 |
| Mailing Telephone | 6023305032 |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | BERTRINA WEST (FOUNDER) |
| Authorized Official Telephone | 6023305032 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 101YP1600X |
Counselor Specialization: Pastoral |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Together Empowered Inc | Other Name - Individual/Organization |
| Street Address |
10475 MEDLOCK BRIDGE RD STE 205 |
| City | DULUTH |
| State | GA |
| Zip Code | 30097-4446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265993927 | Bertrina Olivia West | Counselor | 10475 Medlock Bridge Rd Ste 205, Duluth, GA 30097-4446 | 2019-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659986057 | Herman Medical Solutions, LLC | Internal Medicine | 10700 Medlock Bridge Road, Suite 207, Duluth, GA 30097 | 2020-09-11 |
| 1649808619 | Kirsty Amber Ramirez | Behavior Technician | 218 Premiere Pkwy #500, Duluth, GA 30097 | 2020-03-27 |
| 1386277820 | Cristina Madalina Niculas | Pharmacist | Kroger Pharmacy 476, 6555 Sugarloaf Parkway, Duluth, GA 30097 | 2020-02-12 |
| 1619514924 | Opesdei Health Solutions | Home Health Aide | 6615 Abbotts Bridge Road, 6615 Abbotts Bridge Road Unit 1111, Johns Creek, GA 30097 | 2019-12-05 |
| 1700422979 | Ria Alexander | Nurse Practitioner | 6300 Hospital Parkway Ste 300, Johns Creek, GA 30097 | 2019-11-22 |
| 1043867765 | Mosesal Zakia White | Nurse Practitioner | 10680 Medlock Bridge Rd #102, Johns Creek, GA 30097 | 2019-08-19 |
| 1982187068 | Lighthouse Clinical Counseling, LLC | Counselor | 3883 Rogers Bridge Road, Suite 601, Duluth, GA 30097 | 2018-09-13 |
| 1376025643 | Faithe Beanne Kimsey | Counselor | 3883 Rogers Bridge Road Nw, Suite 601, Duluth, GA 30097 | 2018-09-04 |
| 1306330303 | Denise Jackson | Prosthetist | 11720 Medlock Bridge Rd Ste 155, Johns Creek, GA 30097 | 2018-06-21 |
| 1407363328 | Berkeley Van Dyke | Physical Therapist | 6335 Hospital Pkwy Ste 316, Johns Creek, GA 30097 | 2017-12-30 |
| Find all providers in zip 30097 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730796608 | Shakeia Brodie | Counselor | 6290 Abbotts Bridge Rd Ste 304, Duluth, GA 30097-1750 | 2020-09-25 |
| 1891324588 | The Lighthouse Behavior Health Center LLC | Counselor | 4099 Buckingham Pl, Duluth, GA 30096-4271 | 2020-04-03 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1194368860 | Anine Patrice Jensen | Counselor | 101 W 2nd St Ste 101, Duluth, MN 55802-5021 | 2019-10-24 |
| 1043875164 | Individual Services | Counselor | 114 W Superior St, Duluth, MN 55802-3000 | 2019-05-03 |
| 1285107029 | Tanya Zeiliger | Counselor | 2601 Cannon Farm Ln, Duluth, GA 30097-4317 | 2019-01-04 |
| 1982187068 | Lighthouse Clinical Counseling, LLC | Counselor | 3883 Rogers Bridge Road, Suite 601, Duluth, GA 30097 | 2018-09-13 |
| 1376025643 | Faithe Beanne Kimsey | Counselor | 3883 Rogers Bridge Road Nw, Suite 601, Duluth, GA 30097 | 2018-09-04 |
| 1720572886 | Jennifer Dreibelbis Hama | Counselor | 3460 Summit Ridge Pkwy Ste 503, Duluth, GA 30096-1621 | 2018-06-21 |
| 1134664311 | Amp Group, LLC | Counselor | 331 West Superior Street, Duluth, MN 55802 | 2016-12-27 |
| Find all providers in DULUTH | ||||
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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.