KEVIN BLACK (NPI# 1699263889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699263889 |
| Entity Type | Individual |
| Full Name | KEVIN BLACK |
| Credential | LICSW |
| Practice Address |
3710 Sw Us Veterans Hospital Rd Portland OR 97239-2964 |
| Practice Telephone | 5032208262 |
| Mailing Telephone | 5032208262 |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LW60535756 | WA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013352863 | Kevin Black | Dentist | 700 Essex St Unit 1a1, Lawrence, MA 01841-4396 | 2013-05-07 |
| 1003995085 | Kevin Hale Black | Dentist | 205th Dental Squadron, Bldg 2417, Mcguire Blvd, Mcguire Afb, NJ 08641 | 2006-11-02 |
| 1285256909 | Kevin Zachary Black | Student in an Organized Health Care Education/Training Program | 100 Peach St Ste 400, Erie, PA 16507-1423 | 2020-05-15 |
| 1710514591 | Kevin Benjamin Black Jr. | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-03-24 |
| 1821644576 | Kevin Black | Behavior Technician | 5601 Arnold Rd Fl 100, Dublin, CA 94568-7726 | 2019-08-16 |
| 1275763393 | Kevin Heath Black | Physical Therapist | 8201 Atlee Rd, Suite D, Mechanicsville, VA 23116-1815 | 2009-07-23 |
| 1558389007 | Kevin J Black | Psychiatry & Neurology | 517 S Euclid Ave, Saint Louis, MO 63110-1007 | 2006-07-17 |
| 1497719603 | Kevin P Black | Orthopaedic Surgery | 30 Hope Dr Ste 2400, Hershey, PA 17033 | 2006-04-14 |
| Street Address |
3710 SW US VETERANS HOSPITAL RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97239-2964 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780688556 | Richard B Ismach | Emergency Medicine | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2005-06-09 |
| 1285233510 | Leann Waggoner | Social Worker | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2999 | 2020-10-19 |
| 1932708260 | Ashley Kinnaman | Social Worker | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2020-10-19 |
| 1407453467 | Jonna Bowles | Social Worker | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2020-10-02 |
| 1255947677 | Audrey Nicole Stuhldreher | Registered Nurse | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2020-09-21 |
| 1578178513 | Nyssa Karchefski-ross | Registered Nurse | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2020-09-15 |
| 1952916967 | David Choi | Registered Nurse | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2020-09-15 |
| 1497360085 | Jason Andrew Wargin | Social Worker | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2020-09-10 |
| 1760096804 | Mathew Arin Hanson | Registered Nurse | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2020-09-05 |
| 1619588803 | Julie Kahler | Psychologist | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2020-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
| 1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
| 1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| 1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
| 1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
| Find all providers in zip 97239 | ||||
| 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 |
|---|---|---|---|---|
| 1063012649 | Kathleen Russell | Social Worker | 7700 Sw Garden Home Rd Apt 23, Portland, OR 97223-7496 | 2020-10-31 |
| 1275131534 | Alice Hacker | Social Worker | 14702 Se Rhone St, Portland, OR 97236-2557 | 2020-10-09 |
| 1598372070 | Kristin Elizabeth Hajny | Social Worker | 9343 Sw Camille Ter, Portland, OR 97223-7042 | 2020-09-28 |
| 1821605759 | Melanie Smith | Social Worker | 4210 N Juneau St, Portland, OR 97203-2063 | 2020-09-24 |
| 1871100867 | Purely Spirit Holistic Health, LLC | Social Worker | 226 Stevens Ave Apt 9, Portland, ME 04102-2263 | 2020-09-24 |
| 1023624780 | Flourish Counseling and Consulting LLC | Social Worker | 8401 Ne Halsey St Ste 107, Portland, OR 97220-5670 | 2020-09-18 |
| 1245845130 | Crescent Psychotherapy | Social Worker | 168 Neal St, Portland, ME 04102-3343 | 2020-09-09 |
| 1861007676 | Yvonne Recchia | Social Worker | 5257 Ne Mlk, Portland, OR 97211-3282 | 2020-09-09 |
| 1447864327 | Gordon Keepers | Social Worker | 3181 Sw Sam Jackson Park Rd # Uhs8-l, Portland, OR 97239-3098 | 2020-09-08 |
| 1609484187 | Julie Pratt | Social Worker | 14 Culver Ln, Portland, CT 06480-1323 | 2020-07-21 |
| Find all providers in PORTLAND | ||||
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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.