Individual provider · Type 1 NPI

Georgia Rose Black, MS

Professional Counselor · New Berlin, WI

NPI number 1497378947 Active

Practice location

4855 S Moorland Rd Ste 150
New Berlin, WI 53151-7495

Call (262) 432-7702 Map

Fax (262) 432-7795

Mailing address

9000 W Wisconsin Ave # Ms 958
Milwaukee, WI 53226-4874

Specialties and licenses

TaxonomyCodeLicense
Art Therapist 221700000XNone listed
Professional Counselor Primary 101YP2500X4665 (WI)

Professional Counselor: Definition to come...

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About NPI 1497378947

Georgia Rose Black, MS's National Provider Identifier is 1497378947, issued on May 19, 2020. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in New Berlin, WI. The record was last updated on Jan 18, 2022.