| Kenyatta Black Counseling Llc | |
|
3939 W Green Oaks Blvd Ste 214 Arlington TX 76016-2793 | |
| (469) 490-1442 | |
| Not Available |
| Full Name | Kenyatta Black Counseling Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3939 W Green Oaks Blvd Ste 214, Arlington, Texas |
| Authorized Official Name and Position | Kenyatta Black (OWNER) |
| Authorized Official Contact | 4694901442 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenyatta Black Counseling Llc 607 Sotogrande St Grand Prairie TX 75051-4456 Ph: (214) 298-2780 | Kenyatta Black Counseling Llc 3939 W Green Oaks Blvd Ste 214 Arlington TX 76016-2793 Ph: (469) 490-1442 |
| NPI Number | 1275010308 |
|---|---|
| Provider Enumeration Date | 07/21/2018 |
| Last Update Date | 07/08/2024 |
| Certification Date | 07/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275010308 | NPI | - | NPPES |
| 284297301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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