| Doctor Name: | RAMON JAFARI BLACK |
| NPI Number: | 1194002568 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA, LLPC |
| License Number: | 6401010735 |
| Business Practice Address: | 2387 E Walton Blvd Auburn Hills, MI - 483261955 |
| Business Phone Number: | 2484756400 |
| Business Fax Number: | 2484756403 |
| Mailing Address: | 151 Summit View Ct, WHITE LAKE |
| State: | MI |
| Postal Code: | 483863520 |
| Phone Number: | 2487955035 |
| Fax Number: | |
| NPI Enumeration Date: | 11/13/2011 |
| NPI Last Update Date: | 11/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401010735 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |