Dr Judith Ann Black, PHD, LPC, LCMHC, NCC in Fairmont, WV

Dr Judith Ann Black, PHD, LPC, LCMHC, NCC is a medicare enrolled "Counselor - Professional" provider in Fairmont, West Virginia. Her current practice location is 207 Fairmont Ave, Fairmont, West Virginia. You can reach out to her office (for appointments etc.) via phone at (681) 404-6869.

Dr Judith Ann Black is licensed to practice in West Virginia (license number 2278) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1003110198.

Contact Information

	Dr Judith Ann Black, PHD, LPC, LCMHC, NCC
	207 Fairmont Ave, Fairmont, WV 26554-2710
	(681) 404-6869
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Judith Ann Black
Gender	Female
Speciality	Counselor - Professional
Location	207 Fairmont Ave, Fairmont, West Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003110198
Provider Enumeration Date: 01/04/2011
Last Update Date: 03/16/2023

Medicare PECOS Information:

PECOS PAC ID: 6406206697
Enrollment ID: I20240222002314

Medical Identifiers

Medical identifiers for Dr Judith Ann Black such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003110198	NPI	-	NPPES
WVTPID009357	Medicaid	WV

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	A8388 (North Carolina)	Secondary
101YP2500X	Counselor - Professional	0701005401 (Virginia)	Secondary
101YP2500X	Counselor - Professional	275728 (North Carolina)	Secondary
101YP2500X	Counselor - Professional	8388 (North Carolina)	Secondary
101YP2500X	Counselor - Professional	2278 (West Virginia)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Judith Ann Black allows following entities to bill medicare on her behalf.

Entity Name	Appalachian Counseling Center Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1568928877 PECOS PAC ID: 5597115782 Enrollment ID: O20231229002926

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Judith Ann Black is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Judith Ann Black, PHD, LPC, LCMHC, NCC 12 Woodcliff Dr, Fairmont, WV 26554-1257 Ph: (910) 689-7100	Dr Judith Ann Black, PHD, LPC, LCMHC, NCC 207 Fairmont Ave, Fairmont, WV 26554-2710 Ph: (681) 404-6869

Reviews and Comments

Counselor in Fairmont, WV

Beatriz Cedeno, PROVISIONAL LICENSE Counselor Medicare: Not Enrolled in Medicare Practice Location: 207 Fairmont Ave, Fairmont, WV 26554 Phone: 681-404-6869
Heather Thurbon, Counselor Medicare: Medicare Enrolled Practice Location: 225 Fairmont Ave, Fairmont, WV 26554 Phone: 681-404-6869 Fax: 681-404-6871
Paulina Kristen Elmo, MSW, LGSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 701 Benoni Ave, Fairmont, WV 26554 Phone: 681-404-6135
Ms. Cindy Jo Wanamaker, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 448 Leonard Ave, Fairmont, WV 26554 Phone: 304-366-7174 Fax: 304-366-7419
Haley Wable, Counselor Medicare: Medicare Enrolled Practice Location: 207 Fairmont Ave, Fairmont, WV 26554 Phone: 681-404-6869
Daniel Robert Six Ii, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1421 Morgantown Ave Apt 1, Fairmont, WV 26554 Phone: 304-904-3759

Dr Judith Ann Black, PHD, LPC, LCMHC, NCC - Medicare Counselor in Fairmont, WV