Individual provider · Type 1 NPI

Brent Matthew Black, LPC

Professional Counselor · Okmulgee, OK

NPI number 1861580375 Active

Practice location

114 N Grand Ave, Suite 419
Okmulgee, OK 74447-4013

Call (918) 756-9411 Map

Mailing address

4105 W Elgin St
Broken Arrow, OK 74012-8621

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X3251 (OK)

Professional Counselor: Definition to come...

7 other providers at this address

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About NPI 1861580375

Brent Matthew Black, LPC's National Provider Identifier is 1861580375, issued on Oct 10, 2006. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Okmulgee, OK. The record was last updated on Jul 8, 2007.