Individual provider · Type 1 NPI

Andrew Black

Mental Health Counselor · Portland, OR

NPI number 1306204193 Active

Practice location

17640 NE Halsey St
Portland, OR 97230-6733

Fax (503) 489-5638

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1306204193

Andrew Black's National Provider Identifier is 1306204193, issued on Feb 8, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Feb 8, 2016.