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Individual

JOSHUA JAY BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN, PMHNP-BC

Contact information

Practice address
10123 ALLIANCE RD STE 240, BLUE ASH, OH 45242-4887
(513) 530-1600
Mailing address
13154 NAVARRE RD SW, BEACH CITY, OH 44608-9749
(330) 417-9497

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.025127
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
SP023693
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104027981
PA
Enumeration date
07/12/2019
Last updated
08/11/2025
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