Individual
ALEXANDER BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSW
Contact information
Practice address
612 E ARKANSAS ST, STAR CITY, AR 71667-4842
(870) 628-4181
(870) 628-5369
Mailing address
2500 RIKE DR, PINE BLUFF, AR 71603-3937
(870) 534-1834
(870) 534-5798
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116378726
—
AR
Enumeration date
06/23/2017
Last updated
06/23/2017
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