Individual provider · Type 1 NPI
Heather Leigh Black, LPCA
Mental Health Counselor · Avon, CT
NPI number
1124627575
Active
Practice location
12 Lakeview Blvd
Avon, CT 06001-3442
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 4255 (CT) |
Mental Health Counselor: Definition to come...
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About NPI 1124627575
Heather Leigh Black, LPCA's National Provider Identifier is 1124627575, issued on Oct 17, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Avon, CT. The record was last updated on Oct 17, 2020.