Individual
MR. JAMES C. BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA CLINICAL PSY.
Contact information
Practice address
815 W HAMLET AVE, HAMLET, NC 28345-2507
(910) 582-7046
(910) 582-7106
Mailing address
815 W HAMLET AVE, HAMLET, NC 28345-2507
(910) 582-7046
(910) 582-7106
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1119
NC
106H00000X
Marriage & Family Therapist
0762
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046NJ
BLUECROSS BLUESHIELD
NC
05
—
3403400
—
NC
Enumeration date
03/27/2007
Last updated
01/05/2010
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