| Doctor Name: | MR. JAMES DANIEL BLACK |
| NPI Number: | 1598978868 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA |
| License Number: | PC007734 |
| Business Practice Address: | 340 S Liberty St Orwigsburg, PA - 179612127 |
| Business Phone Number: | 5703661154 |
| Business Fax Number: | 5703667711 |
| Mailing Address: | 21 S Lincoln Ave, LEBANON |
| State: | PA |
| Postal Code: | 170425466 |
| Phone Number: | 7172155469 |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2007 |
| NPI Last Update Date: | 08/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC007734 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |