| Doctor Name: | CRAIG STUART BLACK |
| NPI Number: | 1073991550 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC-INTERN LCDC NCC |
| License Number: | 12460 |
| Business Practice Address: | 2601 Sagebrush Dr Suite 104 Flower Mound, TX - 750282733 |
| Business Phone Number: | 9724795178 |
| Business Fax Number: | |
| Mailing Address: | 2601 Sagebrush Dr, Suite 104 FLOWER MOUND |
| State: | TX |
| Postal Code: | 750282733 |
| Phone Number: | 9724795178 |
| Fax Number: | |
| NPI Enumeration Date: | 05/15/2015 |
| NPI Last Update Date: | 05/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 12460 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |