| Dr. Nicole Black, Phd, Lpc-s, Lcdc, Rpt Pllc | |
|
4601 66th St Ste D Lubbock TX 79414-4875 | |
| (806) 630-0126 | |
| (806) 722-5225 |
| Full Name | Dr. Nicole Black, Phd, Lpc-s, Lcdc, Rpt Pllc |
|---|---|
| Speciality | Counselor |
| Location | 4601 66th St Ste D, Lubbock, Texas |
| Authorized Official Name and Position | Nicole Black (MANAGING PARTNER) |
| Authorized Official Contact | 8066300126 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Nicole Black, Phd, Lpc-s, Lcdc, Rpt Pllc 4601 66th St Ste D Lubbock TX 79414-4875 Ph: (806) 630-0126 | Dr. Nicole Black, Phd, Lpc-s, Lcdc, Rpt Pllc 4601 66th St Ste D Lubbock TX 79414-4875 Ph: (806) 630-0126 |
| NPI Number | 1780270173 |
|---|---|
| Provider Enumeration Date | 12/18/2020 |
| Last Update Date | 06/07/2025 |
| Certification Date | 06/07/2025 |
| Medicare PECOS PAC ID | 6901330513 |
|---|---|
| Medicare Enrollment ID | O20241105001715 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780270173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Nicole Lynn Black |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477935351 PECOS PAC ID: 7719411321 Enrollment ID: I20241105001879 |
| Provider Name | Britni Huntley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396525127 PECOS PAC ID: 8325568512 Enrollment ID: I20250218002543 |
| Provider Name | Shelby Padgett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497580617 PECOS PAC ID: 8628598828 Enrollment ID: I20250218002868 |
| Provider Name | Hunter Shade |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457083149 PECOS PAC ID: 2668992298 Enrollment ID: I20250225003927 |
| Provider Name | Stephanie Choi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114406097 PECOS PAC ID: 0143742726 Enrollment ID: I20250324002593 |
| Provider Name | Kristine Mills |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750891347 PECOS PAC ID: 0547629958 Enrollment ID: I20250501001317 |
| Provider Name | Mirandi Jean Edwards |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760948731 PECOS PAC ID: 3678090321 Enrollment ID: I20250507000566 |
Gabrielle K Keenum Ma Lpc Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6309 Indiana Ave Ste D, Lubbock, TX 79413 Phone: 806-790-1327 Fax: 806-863-3874 | |
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Lubbock Accident & Injury Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5201 Indiana Ave, Lubbock, TX 79413 Phone: 806-793-7246 | |
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Denovo Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2345 50th St Ste 501, Lubbock, TX 79412 Phone: 806-370-3157 Fax: 806-243-4002 | |
G. Gary Walker, Ph.d., P.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5120 29th Dr Ste D, Lubbock, TX 79407 Phone: 806-798-8855 Fax: 806-792-5715 | |
Swmh Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4413 71st St Ste G101, Lubbock, TX 79424 Phone: 806-438-8089 |