JOHANNA CATHERINE BLACK (NPI# 1174908099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174908099 |
| Entity Type | Individual |
| Full Name | JOHANNA CATHERINE BLACK |
| Credential | MSW, LCSW |
| Practice Address |
1501 Yarmouth Ave Boulder CO 80304-0564 |
| Mailing Address |
Po Box 725 Lyons CO 80540-0725 |
| Practice Telephone | 4135700534 |
| Mailing Telephone | 6179717844 |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2018-09-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
LSW.0009920730 | CO | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CSW.09924311 | CO | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336773779 | Johanna D Black | Behavior Technician | 345a Greenwood St, Worcester, MA 01607-1753 | 2020-02-25 |
| Street Address |
1501 YARMOUTH AVE |
| City | BOULDER |
| State | CO |
| Zip Code | 80304-0564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710036132 | Judith Cass Halloran | Counselor | 1501 Yarmouth Ave, Boulder, CO 80304-0564 | 2007-01-09 |
| 1619575776 | Cassandra Keller | Counselor | 1501 Yarmouth Ave, Boulder, CO 80304-0564 | 2020-10-12 |
| 1396372462 | Taylor Sallee | Counselor | 1501 Yarmouth Ave, Boulder, CO 80304-0564 | 2020-03-26 |
| 1659908127 | Heath Ellis | Counselor | 1501 Yarmouth Ave, Boulder, CO 80304-0564 | 2020-03-25 |
| 1689214553 | Rebecca Sue Diaz | Counselor | 1501 Yarmouth Ave, Boulder, CO 80304-0564 | 2020-01-08 |
| 1356986954 | Elyse Bassman | Counselor | 1501 Yarmouth Ave, Boulder, CO 80304-0564 | 2019-11-07 |
| 1497216105 | Allison Renee Heistand-phelps | Counselor | 1501 Yarmouth Ave, Boulder, CO 80304-0564 | 2019-03-26 |
| 1245712223 | Anissa Marie Corser | Social Worker | 1501 Yarmouth Ave, Boulder, CO 80304-0564 | 2018-09-05 |
| 1962997304 | Braxton Massey Dudley Jr. | Counselor | 1501 Yarmouth Ave, Boulder, CO 80304-0564 | 2018-06-27 |
| 1194230128 | Noah Keats Sall | Counselor | 1501 Yarmouth Ave, Boulder, CO 80304-0564 | 2017-12-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720605256 | Evol.v Chiropractic LLC | Chiropractor | 2401 Broadway #208, Boulder, CO 80304 | 2020-07-01 |
| 1760038723 | Patrica Anne Zeyher | Counselor | 100 Alpine Ave., Boulder, CO 80304 | 2019-08-15 |
| 1356855928 | Opal Counseling Center, LLC | Counselor | 1480 Lee Hill Dr. #7, Boulder, CO 80304 | 2017-11-19 |
| 1831608603 | Lesley Ann Cloke | Dietitian, Registered | 1895 Bluff St., Unit C, Boulder, CO 80304 | 2017-09-25 |
| 1790209740 | Megan Litwiller | Occupational Therapist | 810 Maxwell Ave, Boulder, CO 80304 | 2017-08-01 |
| 1285163774 | Nadine Martin | Registered Nurse | 311 Mapleton Ave # 331, Boulder, CO 80304 | 2017-06-08 |
| 1598119281 | Megan Cronin Larson | Social Worker | 825 S. Broadway Street, Boulder, CO 80304 | 2016-04-19 |
| 1760844237 | Rafia Rebeck | Counselor | 1235 Elder Ave #7, Boulder, CO 80304 | 2016-03-24 |
| 1629441688 | Jennifer S Delaney | Counselor | 2334 Broadway, Ste. B, Boulder, CO 80304 | 2015-11-12 |
| 1891162301 | Kingston Dialysis LLC | Clinic/Center | 2880 Folsom St Ste 110, Boulder, CO 80304 | 2015-09-01 |
| Find all providers in zip 80304 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265031454 | Jonathan William Garson | Social Worker | 1790 30th St., Boulder, CO 80301 | 2020-10-20 |
| 1821603085 | Timothy Kleinknecht | Social Worker | 3250 Oneal Cir Apt J36, Boulder, CO 80301-1469 | 2020-09-14 |
| 1831708205 | Center for Valued Living, Pllc | Social Worker | 2825 Marine St Ste 204, Boulder, CO 80303-1027 | 2020-07-30 |
| 1528688140 | Eandd, LLC | Social Worker | 1320 Ithaca Dr, Boulder, CO 80305-6334 | 2020-04-23 |
| 1720639065 | Melissa Thompson | Social Worker | 6007 Oreg Ave, Boulder, CO 80303-1314 | 2019-09-27 |
| 1609426469 | Cathy Summer | Social Worker | 350 Ponca Place, Suite 250, Boulder, CO 80303-3875 | 2019-09-13 |
| 1578126264 | Lenora Rae Schlosser | Social Worker | 2653 Juniper Ave, Boulder, CO 80304-2459 | 2019-04-17 |
| 1619438074 | Wendie J. Vanderwater | Social Worker | 110 Venture Way, Boulder, MT 59632 | 2019-03-28 |
| 1720545148 | Ann Weatherby | Social Worker | 1249 Harrison Ct, Boulder, CO 80303-1138 | 2019-02-21 |
| 1700359460 | Sarah Corrie Shapiro | Social Worker | 121 Kelly Rd E, Boulder, CO 80302-9670 | 2019-01-05 |
| Find all providers in BOULDER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.