Individual provider · Type 1 NPI

Samantha Black, M.A.

Mental Health Counselor · Portland, OR

NPI number 1740684448 Active

Practice location

310 NE Flanders
Portland, OR 97209

Call (503) 827-3949 Map

Mailing address

PO Box 8459
Portland, OR 97207-8459

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed
Case Manager/Care Coordinator 171M00000XNone listed

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About NPI 1740684448

Samantha Black, M.A.'s National Provider Identifier is 1740684448, issued on Oct 9, 2014. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Oct 9, 2014.