Individual provider · Type 1 NPI
Robert D. Black, LPC, CRC
Professional Counselor · San Dimas, CA
NPI number
1629583471
Active
Practice location
518 N Darwood Ave
San Dimas, CA 91773-1600
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor | 101YP2500X | LPC007406 (GA) |
| Rehabilitation Counselor | 225C00000X | 108223 (CA) |
| Rehabilitation Counselor | 225C00000X | 108223 (GA) |
| Professional Counselor Primary | 101YP2500X | LPC308 (CA) |
Professional Counselor: Definition to come...
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About NPI 1629583471
Robert D. Black, LPC, CRC's National Provider Identifier is 1629583471, issued on Dec 1, 2017. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in San Dimas, CA. The record was last updated on Sep 24, 2024.