Individual
MS. BARBARA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., LCAS
Contact information
Practice address
1329 ROBESON ST, FAYETTEVILLE, NC 28305-5531
(910) 438-0939
Mailing address
2004 GLENWICK DR, FAYETTEVILLE, NC 28304-1430
(910) 826-9245
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215
LICENSED CLINICAL ADDICTIONS SPECIALIST
NC
05
—
6112006
—
NC
Enumeration date
10/12/2006
Last updated
06/25/2008
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