Doctor Name: | DARRYL S BLACK |
NPI Number: | 1780889667 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC., LCADC |
License Number: | 37LC00026500 |
Business Practice Address: | 3 Mccabe Ct Little Ferry, NJ - 076432113 |
Business Phone Number: | 2014402998 |
Business Fax Number: | |
Mailing Address: | 3 Mccabe Ct, LITTLE FERRY |
State: | NJ |
Postal Code: | 076432113 |
Phone Number: | 2014402998 |
Fax Number: | |
NPI Enumeration Date: | 06/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 37LC00026500 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |