DR. SHANNON L BLACK (NPI# 1679595300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679595300 |
| Entity Type | Individual |
| Full Name | DR. SHANNON L BLACK |
| Credential | PH.D |
| Practice Address |
6120 Havelock Ave Suite B Lincoln NE 68507-1278 |
| Mailing Address |
4949 Ashland Road Po Box 533 Ceresco NE 68017 |
| Practice Telephone | 4024320745 |
| Mailing Telephone | 4024320745 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
422 | NE | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528448271 | Shannon Trice Black | Counselor | 1900 Manakin Rd Ste G, Manakin Sabot, VA 23103-2252 | 2015-06-08 |
| 1134413438 | Shannon Nichole Black | Chiropractor | 3803 Palmer Park Blvd, Suite B, Colorado Springs, CO 80909-2600 | 2011-06-03 |
| 1063948248 | Shannon Black | Developmental Therapist | 550 N Reo St, Tampa, FL 33609-1061 | 2017-05-07 |
| 1528590031 | Shannon Black | Student in an Organized Health Care Education/Training Program | 60 Daggett Dr, San Jose, CA 95134-2108 | 2017-04-03 |
| 1649668567 | Shannon Elizabeth Black | Counselor | 1921 Ransom Pl, Nashville, TN 37217-3841 | 2014-12-30 |
| 1629184213 | Shannon Black | Physical Therapist | 4100 Lake Otis Pkwy, Ste 106, Anchorage, AK 99508-5222 | 2006-08-23 |
| Street Address |
6120 HAVELOCK AVE SUITE B |
| City | LINCOLN |
| State | NE |
| Zip Code | 68507-1278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164955381 | Lincoln Public Schools | Local Education Agency (LEA) | 4016 North 68th Street, Lincoln, NE 68507 | 2017-04-05 |
| 1992144026 | Laurie Bayless | Community Health Worker | 4112 Touzalin Ave, Lincoln, NE 68507 | 2013-06-21 |
| 1952601106 | Prestige Family Chiropractic and Rehab PC | Chiropractor | 2800 N. 83rd St., Suite E, Lincoln, NE 68507 | 2010-10-21 |
| 1790933083 | Wal-mart Stores, Inc. | Eyewear Supplier (Equipment, not the service) | 3400 North 85th St., Lincoln, NE 68507 | 2008-08-29 |
| 1750435137 | David C Zieg | Dentist | 6301 Havelock Ave, Lincoln, NE 68507 | 2007-01-22 |
| 1790721272 | Havelock Chiropractic Center PC | Chiropractor | 6132 Havelock Avenue, Suite A, Lincoln, NE 68507 | 2006-06-21 |
| 1215971122 | David Walter Lauer | Chiropractor | 6132 Havelock Ave, Suite A, Lincoln, NE 68507 | 2006-06-15 |
| 1124546874 | Matthew Michael Burk | Speech-Language Pathologist | 2635 N 63rd St, Lincoln, NE 68507 | 2017-09-01 |
| 1366612665 | Kontras and Palmer Dds PC | Dentist | 6129 Havelock Ave, Lincoln, NE 68507-1234 | 2008-03-03 |
| 1184953549 | James Douglas Palmer | Dentist | 6129 Havelock Ave, Lincoln, NE 68507-1234 | 2009-12-14 |
| Find all providers in zip 68507 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568018646 | Taralyn Marie Meskowsky | Psychologist | 1871 Garington Ln, Lincoln, CA 95648-7203 | 2019-08-14 |
| 1033600606 | Michael Alfred Raciti | Psychologist | 12 Wingate Rd, Lincoln, RI 02865-4721 | 2018-05-19 |
| 1396235503 | Eric A Harris | Psychologist | 138 Bedford Rd, Lincoln, MA 01773-2707 | 2018-05-14 |
| 1225535990 | Eckert Psychological Services | Psychologist | 8925 Foxtail Dr, Lincoln, NE 68526-9518 | 2018-04-10 |
| 1003331679 | Brigham S Scott | Psychologist | 1530 S 70th St Ste 102, Lincoln, NE 68506-1567 | 2017-08-04 |
| 1811441991 | Stanley R Carlock Ed D LLC | Psychologist | 1001 S 70th St Ste 107, Lincoln, NE 68510-7901 | 2016-08-06 |
| 1285005892 | Cameron White | Psychologist | 1617 Normandy Ct Ste 100, Lincoln, NE 68512-1474 | 2015-10-08 |
| 1366811432 | Amy L Chatelain PC | Psychologist | 2001 Pine Lake Rd, Ste 350, Lincoln, NE 68512-3651 | 2015-09-18 |
| 1841601119 | Cindy L. Nash, Ph.d., PC | Psychologist | 7120 S 29th St Ste 200, Lincoln, NE 68516-5802 | 2014-05-08 |
| 1538478789 | Myla Browne | Psychologist | Lincoln Regional Center Building 3, W. Prospector Place and Folsom St., Lincoln, NE 68509-4949 | 2010-10-05 |
| Find all providers in LINCOLN | ||||
Please comment or provide details below to improve the information on DR. SHANNON L BLACK.
| 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.