Travis Black, is a
Counselor - Mental Health based in Blanding, Utah. Travis Black is licensed to practice in * (Not Available) (license number ) and his current practice location is
735 S 200 W Ste 1, Blanding, Utah. He can be reached at his office (for appointments etc.) via phone at
(435) 678-2992.
NPI number for Travis Black is 1356997134 and his current mailing address is 735 S 200 W Ste 1, Blanding, Utah. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1356997134.
Healthcare Provider's Profile
| Full Name | Travis Black |
|---|
| Gender | Male |
|---|
| Speciality | Counselor - Mental Health |
|---|
| Location | 735 S 200 W Ste 1, Blanding, Utah |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1356997134
- Provider Enumeration Date: 08/16/2019
- Last Update Date: 08/16/2019
Medical Identifiers
Medical identifiers for Travis Black such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1356997134 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Travis Black is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Travis Black,
735 S 200 W Ste 1,
Blanding, UT 84511-3923
Ph: (435) 678-2992 | Travis Black,
735 S 200 W Ste 1,
Blanding, UT 84511-3923
Ph: (435) 678-2992 |
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