| Doctor Name: | VANESSA BLACK |
| NPI Number: | 1003246810 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MAED, CSOTP, LPC NCC |
| License Number: | 10278 |
| Business Practice Address: | 1000 S Main St Suite 2 Laurinburg, NC - 283524764 |
| Business Phone Number: | 9103842175 |
| Business Fax Number: | 8778982026 |
| Mailing Address: | 18201 Sneads Grove Rd, LAURINBURG |
| State: | NC |
| Postal Code: | 283523061 |
| Phone Number: | 9103842175 |
| Fax Number: | 8778982026 |
| NPI Enumeration Date: | 11/14/2013 |
| NPI Last Update Date: | 04/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 10278 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |